Role of phenytoin in the management of neurogenic cancer pain

Anticonvulsants are a group of medicines commonly used for treating 'fits' or epilepsy, but are also effective for pain. The type of pain which responds well is neurogenic (neuropathic) pain. Although anticonvulsants are used widely in chronic pain, as it is less effective in acute pain, surprisingly few studies (consists of case reports and open studies) showed analgesic effectiveness in cancer pain. Neurogenic pain is often very resistant to treatment. Tricyclic antidepressants, anticonvulsants, membrane stabilizers and capsaicin can relieve neurogenic pain in different proportions. Anticonvulsants have differing modes of action and therefore failure to respond to one, does not imply that others may not work. There is a need for further controlled studies of anticonvulsants in both peripheral and central neurogenic pain. We are presenting a case report of soft tissue sarcoma of right scapular region that giving rise to neurogenic pain which was relieved with Phenytoin after trying multiple medications.

DOI: http://dx.doi.org/10.4038/slja.v19i2.4246  

Sri Lankan Journal of Anaesthesiology Vol.19(2) 2011 pp.89-90