Systematic Review of Pharmacologic Treatments of Pain After Spinal Cord Injury: An Update

作者：Mehta Swati^*; McIntyre Amanda; Janzen Shannon; Loh Eldon; Teasell Robert

来源：Archives of Physical Medicine and Rehabilitation, 2016, 97(8): 1381-1391.

DOI：10.1016/j.apmr.2015.12.023

• Pain
• Rehabilitation
• Spinal cord injuries

Objective: To update a systematic review of published research on pharmacotherapy for pain post-spinal cord injury (SCI).
Data Sources: PubMed/MEDLINE, ONAHL 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.

• 出版日期2016-8