Journal of the Medical Sciences (Berkala Ilmu Kedokteran)
Vol 51, No 1 (2019)

Critical appraisal of neuropathic pain guidelines in Asia

Rizaldy Taslim Pinzon (Faculty of Medicine, Duta Wacana Christian University, Yogyakarta,)
Rosa De Lima Renita Sanyasi (Panti Rapih Hospital, Yogyakarta, Indonesia)



Article Info

Publish Date
11 Apr 2019

Abstract

Neuropathic pain (NP) is type of chronic pain that is common and often difficult to treat. Clinicians may be guided by a number of published guidelines and algorithms for the management of neuropathic pain. It is important for every clinician to know the quality of guidelines. The availability of current guideline in Asian countries is not well understood. Critical appraisal of NP guidelines in Asia has not performed, yet. The aim of this study was to appraise the quality of pharmacological treatment from neuropathic pain guidelines in Asia. Systematic searches were conducted by using combination of keywords i.e NP, Asia, and guideline. Guidelines evaluation was using appraisal of guidelines for research & evaluation II (AGREE II) instrument. The result interpreted as (i) a strongly recommended for use in practice if most domains scored above 50%; (ii) recommended for use with some modification if most domains scored between 30% to 50%; or (iii) not recommended for use in practice if most domains scored below 30%. After matched to inclusion and exclusion criteria there were 5 guidelines left: a guideline from Philippines, China, South Korea, Malaysia and Middle East. All of guidelines are recommended for use with some modification. The guidelines mention that first line treatment for NP are tricyclic antidepressants, selective norepinephrine reuptake inhibitor (SNRI) and alpha 2-delta ligand calcium channel blocker (CCB). Most of the evidences come from peripheral NP. There were limited evidences for the treatment of central neuropathic pain (central post stroke pain and pain after spinal cord injury). All the existing guideline mention, that the first line treatment for neuropathic are the tricyclic antidepressants, SNRI and alpha 2-delta ligand CCB.

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Journal Info

Abbrev

bik

Publisher

Subject

Immunology & microbiology Neuroscience

Description

Journal of the Medical Sciences (JMedSci) or Berkala Ilmu Kedokteran (BIK) is an international, open-access, and double-blind peer-reviewed journal, published by Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada Yogyakarta Indonesia. JMedSci aiming to communicate high-quality ...