A retrospective clinical trial of gabapentin combined with duloxetine for the treatment of neuropathic pain after maxillofacial fracture

Abstract

Background & Objectives: Neuropathic pain (NPP) following a maxillofacial fracture can decrease patients’ quality of life and lead to numerous mental and psychological issues. However, using gabapentin alone for neuralgia only yields moderate results. Consequently, this study’s primary objective was to examine the effectiveness and safety of combining gabapentin and duloxetine to alleviate NPP subsequent to a maxillofacial fracture.

Methods: In this retrospective study, we examined patients diagnosed with NPP following maxillofacial fractures from January 2017 to December 2023 at our hospital. All patients received a combination of gabapentin and duloxetine for a 12-week period. We evaluated the effects of this combination on patients using the Visual Analog Scale (VAS), the Pittsburgh Sleep Quality Index (PSQI), the Self-Assessment Scale for Anxiety (SAS), the Hamilton Assessment of Depression (HAMD), and the 36-item Short-Form Survey (SF-36).

Results: This study included a total of 63 patients. After treatment combining gabapentin and duloxetine, there was a significant decrease in VAS, SAS, HAMD, and PSQI scores (P<0.001). There was also a significant improvement in life quality (P<0.05). Sleep staging results showed improved sleep quality post- treatment. Patients experienced longer total sleep time (P<0.001), fewer awakenings (P<0.05), and reduced awakening duration (P<0.05). Furthermore, stress duration six months post-treatment was significantly shortened (P<0.05).

Conclusions: This study indicated that the combined treatment of gabapentin and duloxetine was highly effective for post-maxillofacial fracture NPP. This combination notably improved patients’ pain levels, overall quality of life, sleep patterns, and levels of anxiety and depression.