Such interventions would have the potential to reduce the prevalence of chronic pain in the population .
Although certain risk factors can identify individuals who are most likely to develop chronic pain , few interventions to prevent chronic pain have been identified .
To facilitate the identification of preventive interventions , an IMMPACT meeting was convened to discuss research design considerations for clinical trials investigating the prevention of chronic pain .
We present general design considerations for prevention trials in population s that are at relatively high risk for developing chronic pain .
The Analgesic Effect of Gabapentin and Mexiletine After Breast Surgery for Cancer
We investigated the analgesic efficacy of mexiletine and gabapentin on  acute and chronic pain associated with cancer breast surgery in 75 patients . They were r and omized to receive , in a double-blinded manner , mexiletine 600 mg/d , gabapentin 1200 mg/d , or placebo for 10 days . Anesthesia was st and ardized , and all patients had access to routine postoperative analgesics on dem and . The visual analog scale score assessed pain at rest and after movement . Three months later , all patients were interviewed to identify intensity of chronic pain and analgesic requirements .  Mexiletine and gabapentin  reduced codeine  consumed from the second to tenth day by 50 % ( P = 0.029;P = 0.018 and P = 0.035 for mexiletine versus control and gabapentin versus control comparisons , respectively ) . Total paracetamol consumption was also reduced during the same time ( P = 0.0085;P = 0.007 and P = 0.011 for the mexiletine and gabapentin groups when compared with the control , respectively ) . Pain at rest and after movement was reduced by both drugs on the third postoperative day . Pain after movement also was reduced by gabapentin between the second and fifth postoperative day . Three months later , the incidence of chronic pain , its intensity , and need for analgesics were not affected by either treatment . However , burning pain was more frequent in the control group ( P = 0.033 )
Such interventions would have the potential to reduce the prevalence of chronic pain in the population .
Although certain risk factors can identify individuals who are most likely to develop chronic pain , few interventions to prevent chronic pain have been identified .
To facilitate the identification of preventive interventions , an IMMPACT meeting was convened to discuss research design considerations for clinical trials investigating the prevention of chronic pain .
We present general design considerations for prevention trials in population s that are at relatively high risk for developing chronic pain .