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Paper Chase 2 - Trial of Pregabalin for Acute and Chronic Sciatica

Andrew Buelt, DO and Joe Weatherly, DO
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04:43
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No me gusta!

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This study added to the body of evidence showing that pregabalin is not effective for the treatment of pain caused by acute or chronic sciatica.

 

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Sylvianne C. -

Hello, my name is Dr. Sylvianne Clément and I work in Ottawa. This paper chase is bringing conflicting data with a conference I went to on acute pain. In april 2017, I went to a conference given by Dr. John Penning (medical director acute pain service at the Ottawa hospital). The conference was about peri-operative pain management challenges. Dr. Penning discussed "new" concept in pain management; the role of anti-hyperalgesic drugs (gabapentinoid (lowest step on ladder), ketamine (middle step on ladder) and IV lidocaine (strongest one)). He also talked about how pronociceptive mechanisms amplify the perceived pain, while anti-nociceptive mechanisms diminish the perceived pain. (Ottawa Anesthesia Primer Ed. Patrick Sullivan - Chapter 17 by Penning and Leung). My question to you guys is --> would that information change the way you use lyrica in acute pain? For me it has; I have been using lyrica in addition to regular NSAIDs and Tylenol with good results. Would it be worth it to do another paper chase on pronociceptive mechanism in acute pain pathophysiology?

Heidi J., MD -

Hi Sylvianne! This is an excellent question! You're right - many of us do use pre-gabalin in acute pain. We also covered pre-gabalin in acute and chronic LBP in the May 2106 Things I Do But Should I chapter.

I'm passing along your comments to the PaperChase and general PCRAP teams to hear their thoughts on it. Thanks!!

Stephen S. -

This is the link to the article: https://www.ncbi.nlm.nih.gov/pubmed/28328324

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Legions of Lesions Full episode audio for MD edition 172:45 min - 81 MB - M4AHippo Primary Care RAP June 2017 Summary 12 MB - PDF

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