Comparative study of gabapentin and chlorpheniramine in the management of postburn pruritus at Kenyatta National Hospital

Abstract

Introduction: Postburn pruritus is a common complication that not only affects healing of the burn wounds but also the patient’s quality of life. Several treatment options including chlorpheniramine have been used with unsatisfactory results. This study compares the efficacy of gabapentin with chlorpheniramine in burns patients suffering from pruritus in an African population.

Main objective: To compare the efficacy of gabapentin to that of chlorpheniramine in the management of postburn pruritus.

Study design: A randomised controlled trial.

Materials and methods: Patients with postburn pruritus were divided into two arms, one receiving  chlorpheniramine and the other gabapentin. Visual Analogue Scale (VAS) was utilised to grade the severity of pruritus as well as subsequent response to treatment. Comparative analysis of the two groups was done using the Mann-Whitney U and Kruskall Wallis tests.

Results: There was a general decrease in the mean VAS score for patients on chlorpheniramine and gabapentin from Day 1 to Day 28: 6.5 to 0.4 for gabapentin and 5.7 to 2.4 for chlorpheniramine respectively. There was an insignificant difference in VAS scores on Day 1 (p-value = .071) and Day 7 (p-value = .905) but thereafter patients administered chlorpheniramine had significantly higher VAS scores as compared to patients administered gabapentin (Day 14 p-value = .002, Day 21 p-value < .001 and Day 28 p-value < .001).

Conclusion: Either chlorpheniramine or gabapentin could be utilised in the management of postburn pruritus. However, patients with high VAS of pruritus respond better when managed with gabapentin.