Effectiveness and Adverse Events of Gabapentinoids as Analgesics for Patients with Burn Injuries: A Systematic Review with Meta-Analysis and Trial Sequential Analysis

Author:

Chiang Liang-Jui1ORCID,Lai Pei-Chun2ORCID,Huang Yen-Ta1ORCID

Affiliation:

1. Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704302, Taiwan

2. Education Centre, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704302, Taiwan

Abstract

(1) Background: Pain after a burn injury is difficult to endure, and emerging studies aim to ascertain the effects of gabapentin and pregabalin as non-opioid treatment options. (2) Methods: We searched for randomised controlled trials (RCTs) in six databases. The risk of bias was assessed using the RoB 2.0 tool. We performed meta-analysis and trial sequential analysis and used the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology for judging the certainty of evidence (CoE). (3) Results: Five RCTs were included. Compared with placebo, gabapentinoids significantly decreased the pain intensity within 24 h (mean difference (MD) = −1.06, 95% confidence interval (CI): −1.47–−0.65) and from 72 h to 9 days (MD = −0.82, 95% CI: −1.16–−0.48), but not after 3 weeks (MD = −0.44, 95% CI: −1.31–0.42). Opioid consumption (mg/day) was reduced within 24 h (MD = −13.34, 95% CI: −22.16–−4.52) and from 72 h to 9 days (MD = −7.87, 95% CI: −14.82–−0.91). Increased risks of drowsiness (risk ratio (RR) = 3.255, 95% CI: 1.135–9.335) and dizziness (RR = 3.034, 95% CI: 1.006–9.147) were observed, but sensitivity analysis using the Bayesian method showed no increased risk. All endpoints were judged as low to very low CoE. (4) Conclusions: Gabapentinoids offer modest analgesic benefits as a component of multimodal pain management for burn injuries of less than 3 weeks. The adverse effects should be carefully monitored. Large-scale RCTs are warranted for the reinforcement of CoE in clinical use.

Funder

Clinical Medicine Research Centre, National Cheng Kung University Hospital, Tainan, Taiwan

Publisher

MDPI AG

Subject

General Medicine

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