Comparative effects of pregabalin and nortriptyline on post-burn neuropathic pain

Abstract

This clinical trial evaluates the effectiveness of nortriptyline and pregabalin in managing chronic pain in burn patients after discharge. Current treatments like acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs) are insufficient, leading to challenges in rehabilitation. This clinical trial is designed to evaluate the effectiveness of two drugs, nortriptyline and pregabalin, in managing chronic post-burn pain and the frequency of their side effects. This double-blind randomized controlled trial involves burn patients experiencing chronic neuropathic pain after hospital discharge, despite standard treatments like acetaminophen and ibuprofen. These patients report pain types such as burning, electric shock, and stabbing, requiring referral to a specialized pain clinic. Pain intensity is measured using the Persian version of the Brief Pain Inventory (BPI-P), where a score of 4 or higher indicates the need for palliative interventions. In this study, 60 patients were treated, 30 with nortriptyline and 30 with pregabalin. The average age was 41.5 years, and the average burn severity was 62%. In the nortriptyline group, the mean pain score decreased from 8.07 to 3.93, while in the pregabalin group, it dropped from 8.07 to 4.47 after treatment. Both groups significantly reduced pain after the intervention (P<0.05). This study shows us that both drugs are effective in reducing neuropathic pain in burn patients and that pregabalin is at least as effective as nortriptyline, and this drug can be a special alternative in cases where side effects such as drowsiness or others cause problems.