Table 3.
Medications Regimens for Neuropathic Pain in General Pediatrics
| Reference | Design and Patients Data: age, diagnostic, type of pain | Main Neuropathic Pain Medication (Additional Neuropathic Pain Medications) |
Analgesic Efficacy Measures | Adverse effects | Duration |
|---|---|---|---|---|---|
| Akkurt 2015 [47] n = 1 |
12 y/o, NP, sciatic nerve injury | Gabapentin 10 mg/kg/day for 2 weeks, followed by 16 mg/kg/day | Considerable improvement of NP symptoms | Light dizziness for the first 2 days of therapy | 2 months |
| Brown 2016 [48] n = 34 |
Randomized control trial: 34 patients, CRPS I or NP, mean (SD) age: amitriptyline group: 13.5 (2.35) gabapentin group: 12.6 (2.52) |
Amitriptyline 10 mg/day, Gabapentin Day 1–3: 300 mg Day 4–6: 300 mg BID Day 7- end: 300 mg TID |
Decrease in CAS score for amitriptyline = 1.50 Decrease in CAS score for gabapentin = 1.77 Sleep scores improved for both |
3 patients: additional pain sites | 6 weeks |
| Butkovic 2006 [24] n = 1/5 |
5 y/o, idiopathic NP |
Gabapentin 10, 20, 30 mg/kg/day for 3 consecutive days, respectively, 2 weeks at maximum dose, maintenance dose 10 mg/kg/day (ibuprofen, amitriptyline)* |
VAS decreased from 9 to 3 | Sedation and fatigue | 1 week |
| Orellana Silva 2013 [49] n = 12 |
Prospective: 12 patients, NP from burn sequelae, mean (SD) age 11 years 7 months (2 years 6 months) | 5% lidocaine patch, 12 hour on, 12 hour off | Mean FACES score decreased from 7 to 0 Mean DN4 score decreased from 6 to 2 |
No adverse effects reported | 3 months |
| Nayak 2008 [54] n = 5 |
12 y/o, surgical scar-related NP post-nephrectomy | One 5% lidocaine patches for 12 hrs/day for 1 month | VAS decreased from 7 to 2 | No adverse effects reported | 3 months |
| 15 y/o, imperforate anus, NP at colostomy site |
Two 5% lidocaine patches for 12 hrs/day for 1 week (gabapentin, amitriptyline)* |
No improvement | No adverse effects related to patch | 1 week | |
| 18 y/o, sacrococcygeal teratoma, scar-related NP post-thoracotomy |
Two 5% lidocaine patch for 12 hrs/day for 3 months (codeine, NSAIDs, paracetamol, gabapentin)* |
VAS decreased from 9 to 0 | No adverse effects reported | 3 months | |
| 11 y/o, congenital heart disease, scar-related NP at femoral catheter entry site |
One 5% lidocaine patch for 12 hrs/day for 3 months (paracetamol, NSAIDs, amitriptyline 10 mg)* |
VAS decreased from 8 to 4 at 3 months and to 3 at 6 months | No adverse effects reported | 4 months | |
| 14 y/o, scar-related NP post laminoplasty | Two 5% lidocaine patches for 12 hrs a day for 3 months | VAS decreased from 8 to 0 at 1 month | No adverse effects reported | 3 months | |
| Taylor 2015 [50] n =14 |
Patients with NP, median (range) age 15.5 (1 month - 23 years) |
Ketamine IV 0.05 to 0.1 mg/kg increased in increments of 0.05 mg/kg every 5 to 10 mins, maximum 0.6 mg/kg (morphine PCA - measure of pain)* |
Decrease in opioid use and decrease in pain | 3 patients, fatigue, imbalance, disorientation, shakiness, slurred speech, agitation, myoclonic jerks, and hemorrhagic cystitis | 7 days (discharged on ketamine) |
| Yazde Puleio 2018 [51] n = 74 |
Patients with various types of NP, 59 cancer, 13 other, mean (SD) age 10.9 (5.36) years | Opioid rotation, morphine as initial opioid in 57 cases, rotation required in 35 patients, most frequent switch - morphine to methadone | Better quality of life | 6 patients had adverse effects (not specified) |
*
Concurrent medications are included as mentioned in the primary source
Abbreviations: NP, neuropathic pain; CRPS, chronic regional pain syndrome; CAS, to check; VAS, visual analog score (0–10); NSAIDs, nonsteroidal anti-inflammatory drugs; PCA, patient-controlled analgesia