Abstract:
Post-burn pruritis is difficult to assess and treat. Antihistamines used in its treatment provide little relief. Identification of the itch neuronal pathway has inspired new alternatives including gabapentin in its management. The study compared the effectiveness of cetirizine, gabapentin, and a combination of gabapentin and cetirizine in treating post-burn pruritus. Burn patients were randomly assigned to treatment with Cetirizine (n=23), Gabapentin (n=23), or Cetirizine plus Gabapentin (n=23). Baseline assessment of the intensity or the severity of pruritus was evaluated after which treatment commenced with standard doses of the three study regimens. Quality of sleep was assessed at baseline (day 0) and repeated on day 3, day 7 and day 14. Approximately 97% of participants presented with moderate or severe itch; 69% with acute itch; and majority (94.2%) experienced pruritus between the first and fourth weeks. Gabapentin reduced itch by 92.9% in 14 days compared to cetirizine\'s 61.8%. The combined effect of cetirizine and gabapentin was comparable to using gabapentin alone. When itch became protracted over 6 weeks, the effectiveness of cetirizine in controlling itch worsened. It reduced itch intensity by only 37.7% whilst gabapentin did so at 89.4%. Itch intensity correlated positively with insomnia and controlling itch intensity improved sleep. Gabapentin was more effective for the treatment of post-burn pruritus than cetirizine. Controlling itch intensity improved sleep. In acute and moderate itch, a low-dose gabapentin could be added if cetirizine is the drug intended for its treatment.
摘要:
烧伤后瘙痒难以评估和治疗。治疗中使用的抗组胺药几乎没有缓解作用。瘙痒神经元途径的鉴定启发了包括加巴喷丁在内的新替代品。该研究比较了西替利嗪的有效性,加巴喷丁,加巴喷丁和西替利嗪联合治疗烧伤后瘙痒。烧伤患者被随机分配到西替利嗪治疗(n=23),加巴喷丁(n=23),或西替利嗪加加巴喷丁(n=23)。在用标准剂量的三种研究方案开始治疗之后,评估瘙痒的强度或严重程度的基线评估。在基线(第0天)评估睡眠质量,并在第3天、第7天和第14天重复。大约97%的参与者出现中度或重度瘙痒;69%的患者出现急性瘙痒;大多数(94.2%)在第一周和第四周之间出现瘙痒。加巴喷丁在14天内减少了92.9%的瘙痒,而西替利嗪为61.8%。西替利嗪和加巴喷丁的联合作用与单独使用加巴喷丁相当。当瘙痒持续超过6周时,西替利嗪控制瘙痒的有效性恶化。它仅将瘙痒强度降低了37.7%,而加巴喷丁则降低了89.4%。瘙痒强度与失眠呈正相关,控制瘙痒强度可改善睡眠。加巴喷丁治疗烧伤后瘙痒比西替利嗪更有效。控制瘙痒强度改善睡眠。在急性和中度瘙痒中,如果西替利嗪是用于治疗的药物,则可以添加低剂量加巴喷丁。