5264
document
The response of neuropathic pain and pain in complex regional pain syndrome I to carbamazepine and sustained-release morphine in patients pretreated with spinal cord stimulation : a double-blinded randomized study . Forty-three patients with peripheral neuropathic pain , exclusively pain reduced by spinal cord stimulation ( SCS ) , were switched into a painful state after SCS inactivation . This mode was used to assess the pain-relieving effect of carbamazepine ( CMZ ) and opioids in a double-blinded , placebo-controlled trial . In Phase 1 , the patients were randomly allocated to receive either CMZ ( 600 mg/d ) or placebo during an SCS-free period of 8 days . In Phase 2 , after a CMZ elimination interval of 7 days , 38 patients received either sustained-release morphine ( 90 mg/d ) or placebo for 8 days . In cases of intolerable pain , the patients were authorized to reactivate their SCS . The pain intensity was rated on a numeric analog scale . In 38 patients who completed Phase 1 , significant delay in pain increase was observed in the CMZ group as compared with placebo ( P = 0.038 ) . In Phase 2 , the trend observed with morphine was insignificant ( P = 0.41 ) . Two CMZ patients and one morphine patient showed complete pain relief and preferred to continue the medication . Thirty-five patients returned to SCS . We conclude that CMZ is effective in peripheral neuropathic pain . Morphine obviously requires larger individually titrated dosages than those used in this study for results to be adequately interpreted .
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Intervention_Pharmacological
carbamazepine
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Intervention_Pharmacological
sustained-release morphine
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Intervention_Pharmacological
carbamazepine ( CMZ )
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Intervention_Pharmacological
opioids
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Intervention_Control
placebo-controlled
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Intervention_Pharmacological
CMZ ( 600 mg/d )
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Intervention_Control
placebo
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Intervention_Pharmacological
CMZ
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Intervention_Pharmacological
sustained-release morphine ( 90 mg/d )
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Intervention_Control
placebo
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Intervention_Pharmacological
SCS .
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Outcome_Pain
neuropathic pain
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Outcome_Pain
pain in complex regional pain syndrome
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Outcome_Pain
intolerable pain
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Outcome_Pain
pain intensity
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Outcome_Other
numeric analog scale
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Outcome_Pain
delay in pain increase
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Outcome_Pain
complete pain relief
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Outcome_Pain
neuropathic pain
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Participant_Condition
complex regional pain syndrome
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Participant_Condition
pretreated with spinal cord stimulation
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Participant_Sample-size
Forty-three
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Participant_Condition
peripheral neuropathic pain
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Participant_Condition
pain reduced by spinal cord stimulation ( SCS )
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Participant_Condition
painful state after SCS inactivation