Article

OBJECTIVE: To update a systematic review of published research on pharmacotherapy
for pain post-spinal cord injury (SCI). DATA SOURCES: PubMed/MEDLINE, CINAHL,
Embase, and PsycINFO databases were searched for articles from 2009 to September
2015 examining treatment of pain post-SCI.
STUDY SELECTION:
Studies were included
for analysis if they met the following 4 a priori criteria: (1) written in the
English language; (2) >/=50% of subjects had an SCI, unless results were
stratified by population type; (3) participants included >/=3 subjects with an
SCI; and (4) any intervention involving pharmacologic treatment for the
improvement of pain. DATA EXTRACTION: Randomized controlled trials were assessed
for methodologic quality using the Physiotherapy Evidence Database scoring
system. All research designs were given a level of evidence according to a
modified Sackett Scale. DATA SYNTHESIS: Seven new studies met our inclusion
criteria. The new studies fell into the following categories: analgesics (n=1),
anticonvulsants (n=2), antidepressants (n=2), antispastics (n=1), and
cannabinoids (n=1).
There was evidence for 5 new pharmacotherapies among the SCI
population; these included the following: oxycodone, duloxetine, venlafaxine,
phenol block, and dronabinol. Levels of evidence for all therapy modalities were
updated based on the new evidence. CONCLUSIONS: Anticonvulsants remain the most
studied and supported pharmacotherapy for neuropathic pain post-SCI.
Antidepressants showed reduction in pain only among those with comorbid
depression. Botulinum toxin and phenol blocks were supported for the reduction of
mixed pain post-SCI.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS