Table 3

 Use of anticonvulsants in patients experiencing pain with Guillain-Barré syndrome

CitationPatient groupStudy typeOutcomesKey resultsStudy weaknesses
*nsd, no significant difference.
Pandey et al (2002), India18 adults with GBS and pain >3 on scale 1–10 All mechanically ventilatedDouble blinded randomised controlled cross over trial. Group 1 given gabapentin for 7 days then after 2 days washout, placebo for 7 days. Group 2 given placebo for 7 days, 2 days washout, then gabapentin1. Improvement of pain scores 2. Use of rescue analgesia (2 μg/kg fentanyl)
3. Ramsey sedation score Period of treatment with gabapentin (PTG) versus period of treatment with placebo (PTP) were directly compared, not one group versus other, due to cross over nature of trial
1. Pain scores during PTG fell from 7.22±0.83, day 0, to 2.06±0.63, day 7 (p<0.001).
Pain scores during PTP fell from 7.83±0.78, day 0, to 5.67±0.91, day 7, (nsd)*.
2. Rescue analgesia in PTG 211.11±21.38 μg, day 1, fell to 65.55±16.17 μg, day 7, (p<0.001).
In PTP 319.44±25.08 µg fell to 316.67±24.25 μg (nsd).
Small numbers
Tripathi and Kaushik (2000), India12 adults with pain complicating GBS All mechanically ventilatedProspective, double blinded, randomly controlled cross over trial. Group 1 given placebo for 3 days, 1 day washout, then 3 days carbamazepine. Group 2 carbamazepine then placebo1. Pain scores on an ordinal scale 1 to 5 2. Use of rescue analgesia (pethidine requirements)
3. Sedation score
1. Group 1 pain scores 4.2±0.6 (control) fell to 3.5±0.6, day 3, (nsd); then fell to 1.5±0.6, day 7, (p<0.001).
Group 2 pain scores 4.7±0.5 (control) fell to 1.2±0.5, day 3, (p<0.001), then rose to 3.0±0, day 7 (nsd).
2. Rescue analgesia: Group 1 4.1±0.9 mg/kg/day fell to 4.5±0.4, day 3, (nsd), then fell to 0.5±0.6, day 7 (p<0.5).
Group 2 3.9±1.0 mg/kg/day fell to 0.2±0.5, day 3, (p<0.5), then rose to 3.6±0.6, day 7 (nsd).
Small numbers Short treatment and washout time