Gabapentin for the treatment of dysesthetic pain after reconstructive surgery

BACKGROUND. Debilitating, postoperative dysesthetic pain after reconstructi ve surgery is a rare but problematic complication. Conventional therapy is either marginally effective or fraught with side effects. Gabapentin is a n ew, novel antiepileptic drug helpful in the management of other pain states . OBJECTIVE. A case of disturbing, postoperative dysesthetic pain after recon structive surgery is presented. METHODS. A trial Of gabapentin in escalating dose was initiated and the res ults and side effects were recorded. RESULTS. Treatment with gabapentin was associated with a substantial decrea se in pain, which relapsed after tapering the medication. Relief was obtain ed with dose escalation, and a successful taper was eventually accomplished . Side effects were minimal. CONCLUSION. This is the first reported use of gabapentin in the treatment o f postoperative dysesthetic pain. Although this type of neuropathic pain is difficult to manage, gabapentin produced substantial relief with few side effects. Further investigation is warranted.