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A multimodal aneurysmal subarachnoid hemorrhage headache treatment protocol was implemented in February 2014. keyword searches for surgery and cancer in reference to gabapentin and pain were Background: Headache after aneurysmal subarachnoid hemorrhage (SAH) is very common and is often described as the “worst headache imaginable.” SAH-associated headache can persist for days to weeks and is traditionally treated with narcotics. However, narcotics can have significant adverse effects. Our primary endpoint was the efficacy of gabapentin in reducing headache numeric pain scores and opioid usage in patients with aSAH compared to the placebo group. We identified 63 potential patients with aSAH for the study. Objective. This narrative review of the literature concerns persistent headache attributed to past non-traumatic subarachnoid hemorrhage (SAH), based off demographic and clinical features, what are pathophysiologic mechanisms by which these headaches occur, which medical and interventional treatments have the most evidence for pain alleviation, and what pre-clinical evidence is there for Background Severe headaches are common after subarachnoid hemorrhage. Guidelines recommend treatment with acetaminophen and opioids, but patient data show that headaches often persist despite multimodal treatment approaches. Considering an overall slim body of data for a common complaint affecting patients with SAH during their intensive care stay, we set out to assess practice patterns in Our institution utilizes a multimodal pharmacotherapy protocol in the management of aneurysmal subarachnoid hemorrhage headache. The purpose of this study was to evaluate the efficacy of the current aneurysmal subarachnoid hemorrhage headache treatment approach at our institution. Safety and tolerability of gabapentin for aneurysmal subarachnoid hemorrhage (SAH) headache and meningismus CPSP and SAH-associated pain: Gabapentin: ICH in rats: Safety and tolerability of gabapentin for aneurysmal subarachnoid hemorrhage (sah) headache and meningismus Aneurysmal subarachnoid hemorrhage (SAH) is a common life-threatening condition that requires specialized multidisciplinary care by neurosurgeons, neurointensivists, and neurointerventionalists in the intensive care unit (ICU) [10]. Despite significant advances in the quality and efficacy of neuro-critical and neuroanesthetic care, SAH patients often experience tremendous pain and discomfort GBP appears to be relatively safe and tolerable in SAH patients with headache and may be a useful narcotic-sparing agent to prevent narcotics-associated complications, such as gastrointestinal immobility, ileus, and constipation. SAH-associated headache can persist for days to weeks and is traditionally treated with narcotics. However, narcotics can have significant adverse effects. We hypothesize that gabapentin (GBP), a non-narcotic neuropathic pain medication, would be safe and tolerable and would reduce narcotic requirements after SAH. The purpose of this study is to see how much gabapentin will reduce headaches associated with subarachnoid hemorrhage (SAH) and to reduce the amount of narcotic pain medication prescribed. Participation eligibility. Participant eligibility includes age, gender, type and stage of disease, and previous treatments or health concerns. If gabapentin reduces the pain and/or improves pain control satisfaction without major side effects it will be drug of choice for headache among patients with SAH with lower cost benefit ratio by decreasing the narcotic requirement. Considering an overall slim body of data for a common complaint affecting patients with SAH during their intensive care stay, we set out to assess practice patterns in headache management among clinicians who treat patients with SAH. Our primary endpoint was the efficacy of gabapentin in reducing headache numeric pain scores and opioid usage in patients with aSAH compared to the placebo group. We identified 63 potential patients with aSAH for the study. After applying stringent exclusion criteria, 16 eligible patients were enrolled into one of two arms. Introduction: Severe, often sudden-onset headache is the principal presenting symptoms of aneurysmal subarachnoid hemorrhage (aSAH). We hypothesized that gabapentin would be safe and tolerable for Citation: Dhakal LP, Turnbull MT, Jackson DA, Edwards E, Hodge DO, Thottempudi N, Kamireddi P, Akinduro OO, Miller DA, Meschia JF and Freeman WD (2020) Safety, Tolerability, and Efficacy of Pain Reduction by Gabapentin for Acute Headache and Meningismus After Aneurysmal Subarachnoid Hemorrhage: A Pilot Study. Front. The current study investigated the use of gabapentin vs. placebo for headache pain relief in patients with aSAH while admitted to a NeuroICU as gabapentin can be used safely for days to weeks for pain management. In a recent cohort study of SAH headache by Morad and colleagues, 89% of patients experienced severe pain (VAS of 7–10/10) at some point during their hospitalization and 94% received opioid analgesia during their course [19]. The use of opioid analgesia is ubiquitous among patients with acute post-subarachnoid hemorrhage headache. OBJECTIVE: We hypothesize that gabapentin (GBP) may be a safe and tolerable option to reduce narcotics and other pain medications after Aneurysmal subarachnoid hemorrhage (aSAH). BACKGROUND: aSAH is characterized by sudden severe headache which can persist for weeks after initial bleeding.
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