Rev. Soc. Esp. Dolor. 2021; 28(2): 71-75 / DOI: 10.20986/resed.2021.3822/2020
J. J. Medina, A. Vega, M. E. Medina, S. G. Coubert
ABSTRACT
Objective: The objective of this study is to evaluate the efficacy and safety of long-acting tapentadol 100 or 200 mg orally every 24 hours for the treatment of Postlaminectomy Syndrome (SPL) in a series of patients with pain neuropathic in ineffective analgesic treatment.
Material and methods: A single-center, longitudinal, prospective and observational study was conducted, in which 30 patients were recruited to the pain clinic of a third-level reference center who suffered from SPL and who met all the inclusion criteria; To whom the Brief Pain Inventory questionnaire in its Spanish version and the Lanss Test were applied before and after starting treatment with tapentadol and a student’s t was applied to compare the overall effectiveness of the treatment of neuropathic pain.
Results: Data from 30 patients were analyzed, of which 19 were women (63.3 %) and 11 were men (36.6 %) with a diagnosis of confirmed SPL and the presentation of neuropathic pain, who were divided into two groups. The first group of 13 patients (43.3 %) received tapentadol at 100 mg orally every 24 hours, and the second group of 17 patients (56.6 %) received 200 mg orally every 24 hours for four weeks. They were followed up for 4 weeks and statistically significant improvement (p value = 0.05) was found in the SPL clinic.
RESUMEN
Objetivo: El objetivo del presente estudio es evaluar la eficacia y seguridad de tapentadol de liberación a 100 o 200 mg vía oral cada 24 horas, de acción prolongada, para el tratamiento del síndrome postlaminectomía (SPL) en una serie de pacientes con dolor neuropático en tratamiento analgésico inefectivo.
Material y métodos: Se realizó un estudio unicéntrico, longitudinal, prospectivo y observacional, en el que se reclutaron 30 pacientes a la clínica de dolor de un centro de referencia de tercer nivel que sufrían de SPL y que cumplían con todos los criterios de inclusión; a quienes se les aplicó el cuestionario Brief Pain Inventory en su versión en español y el test de Lanss antes y después de iniciar tratamiento con tapentadol, y se aplicó una t de Student para comparar la efectividadglobal del tratamiento del dolor neuropático.
Resultado: Se analizaron datos de 30 pacientes, de los cuales 19 fueron mujeres (63,3 %) y 11 hombres (36,6 %) con diagnóstico de SPL confirmado y con características de dolor de tipo neuropático, quienes fueron divididos en dos grupos: el primer grupo de 13 pacientes (43,3 %) recibió tapentadol a 100 mg vía oral cada 24 horas y el segundo de 17 pacientes (56,6 %) recibió 200 mg vía oral cada 24 horas por cuatro semanas. Se les dio un seguimiento de 4 semanas y se encontró una disminución estadísticamente significativa (valor de p = 0,05) del dolor neuropático en la consulta subsecuente de la clínica del SPL.
Nuevo comentario
Comentarios
No comments in this article
Bibliografía
1. Blond S, Mertens P, David R, Roulaud M, Rigoard P. From "mechanical" to "neuropathic" back pain concept in FBSS patients. A systematic review based on factors leading to the chronification of pain (part C). Neurochirurgie. 2015;61(Suppl 1):S45-56. DOI: 10.1016/j.neuchi.2014.11.001.
2. Al Kaisy A, Pang D, Desai MJ, Pries P, North R, Taylor RS, et al P. Failed back surgery syndrome: who has failed? Neurochirurgie. 2015;61(Suppl 1):S6-S14. DOI: 10.1016/j.neuchi.2014.10.107.
3. Finnerup NB, Haroutounian S, Kamerman P, Baron R, Bennett DLH, Bouhassira D, et al. Neuropathic pain: an updated grading system for research and clinical practice. Pain. 2016;157(8):1599-606. DOI: 10.1097/j.pain.0000000000000492.
4. Bailey JC, Kurklinsky S, Sletten CD, Osborne MD. The Effectiveness of an Intensive Interdisciplinary Pain Rehabilitation Program in the Treatment of Post-Laminectomy Syndrome in Patients Who Have Failed Spinal Cord Stimulation. Pain Med. 2018;19(2):385-92. DOI: 10.1093/pm/pnx060.
5. Tzschentke TM, Jahnel U, Kogel B, Christoph T, Englberger W, De Vry J, et al. Tapentadol hydrochloride: a next-generation, centrally acting analgesic with two mechanisms of action in a single molecule. Drugs Today (Barc). 2009;45(7):483-96. DOI: 10.1358/dot.2009.45.7.1395291.
6. Singh DR, Nag K, Shetti AN, Krishnaveni N. Tapentadol hydrochloride: A novel analgesic. Saudi J Anaesth. 2013;7(3):322-6. DOI: 10.4103/1658-354X.115319.
7. Schröder W, Vry JD, Tzschentke TM, Jahnel U, Christoph T. Differential contribution of opioid and noradrenergic mechanisms of tapentadol in rat models of nociceptive and neuropathic pain. Eur J Pain. 2010;14(8):814-21. DOI: 10.1016/j.ejpain.2010.05.005.
8. Hartrick CT, Rozek RJ. Tapentadol in pain management: a μ-opioid receptor agonist and noradrenaline reuptake inhibitor. CNS Drugs. 2011;25(5):359-70. DOI: 10.2165/11589080-000000000-00000.
9. Caputi FF, Nicora M, Simeone R, Candeletti S, Romualdi P. Tapentadol: an analgesic that differs from classic opioids due to its noradrenergic mechanism of action. Minerva Med. 2019;110(1):62-78. DOI: 10.23736/S0026-4806.18.05909-8.
10. Steigerwald I, Schenk M, Lahne U, Gebuhr P, Falke D, Hoggart B. Effectiveness and tolerability of tapentadol prolonged release compared with prior opioid therapy for the management of severe, chronic osteoarthritis pain. Clin Drug Investig. 2013;33(9):607-19. DOI: 10.1007/s40261-013-0102-0.
11. Kress HG, Coluzzi F. Tapentadol in the management of cancer pain: current evidence and future perspectives. J Pain Res. 2019;12:1553-60. DOI: 10.2147/JPR.S191543.
12. Deeks ED. Tapentadol Prolonged Release: A Review in Pain Management. Drugs. 2018;78(17):1805-16. DOI: 10.1007/s40265-018-1007-2.
13. Baron R, Martin-Mola E, Müller M, Dubois C, Falke D, Steigerwald I. Effectiveness and Safety of Tapentadol Prolonged Release (PR) Versus a Combination of Tapentadol PR and Pregabalin for the Management of Severe, Chronic Low Back Pain With a Neuropathic Component: A Randomized, Double-blind, Phase 3b Study. Pain Pract. 2015;15(5):455-70. DOI: 10.1111/papr.12200.
Artículos relacionados
Pain: a "hotchpotch"
Rev. Soc. Esp. Dolor. 2020; 27(4): 278-280 / DOI: 10.20986/resed.2016.3507/2016