Gabapentinoids Associated With Lower Explantation Rate in 203 Patients With Spinal Cord Stimulation for Failed Back Surgery Syndrome
| Autor: | Tiina-Mari Ikäheimo, Henna-Kaisa Jyrkkänen, Jukka Huttunen, Mikael von und zu Fraunberg, Mette Nissen, Ville Leinonen |
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| Rok vydání: | 2021 |
| Předmět: |
Neuros/4
AcademicSubjects/MED00930 law.invention 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Randomized controlled trial 030202 anesthesiology law Humans Medicine Prospective Studies Spinal Cord Stimulation integumentary system business.industry Hazard ratio Treatment Outcome Research—Human—Clinical Studies Spinal Cord chemistry Opioid Concomitant Anesthesia Cohort Neuropathic pain Morphine Neuralgia Surgery Neurology (clinical) Failed back surgery syndrome business Neuropathic pain medication 030217 neurology & neurosurgery Gabapentinoid medicine.drug |
| Zdroj: | Neurosurgery |
| ISSN: | 1524-4040 0148-396X |
| DOI: | 10.1093/neuros/nyab242 |
| Popis: | BACKGROUND Spinal cord stimulation (SCS) is an effective treatment in failed back surgery syndrome (FBSS). The effect of neuropathic pain medication use on SCS outcome is poorly understood. OBJECTIVE To study the effect of gabapentinoid use on SCS outcome measured by trial success, explantation rate and opioid dose reduction during a 2-yr follow-up. METHODS The study cohort included 203 consecutive FBSS patients who underwent SCS in a single tertiary center during January 1997 to March 2014. Purchase data of gabapentinoids, opioids, tricyclic antidepressants, serotonin and noradrenaline reuptake inhibitors, and benzodiazepines during January 1995 to March 2016 were retrieved from national registries. RESULTS In multivariate Cox regression analysis, patients using gabapentinoids had significantly fewer explantations during the 2-yr follow-up (hazard ratio [HR] 0.2, 95% CI 0.04-0.81, P = .03). In contrast, patients with opioid use of >40 morphine milligram equivalent before implantation had significantly more explantations (HR 6.7, 95% CI 2.5-18, P 50% dose reduction. This indicates that patients with SCS could benefit from concomitant use of gabapentinoids. Prospective randomized trials are warranted to verify this hypothesis. |
| Databáze: | OpenAIRE |
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