Objective  To observe the effect of transdermal fentanyl combined with gabapentin for the treatment of malignant neuropathic pain (MNP).

  Methods  A total of 60 patients with MNP were randomly divided into two groups. A total of 30 cases in the control group received transdermal fentanyl according to the dosages of opioid medicine that patients used. Such dosages were gradually increased until the pain relief visual analogue scale (VAS) fell below 3 or until the times of breakthrough pain became less than 3. For the combined group, gabapentin was co-administered with transdermal fentanyl, similar to the control group. Initially, 100 mg of gabapentin was administered thrice a day. This dosage was gradually increased until pain relief. However, gabapentin dosages were kept below 2, 400 mg a day. VAS, quality of life (QOL), degree of pain relief, dosages of fentanyl and morphine, and side effects were evaluated before treatment and at one, two, three, and four weeks after the treatment.

  Results  Both groups exhibited lower VAS after treatment (P < 0.05), but the difference was observed to be more significant in the combined group than that in the control group (P < 0.05). Both groups exhibited improved QOL (P < 0.05), which was observed to be more significant in the combined group than in the control group (P < 0.05). The effective rate was 96.7% in the combined group and 83.3% in the control group. The dosage of opioid medicine and the side effects in the combined group were less than those in the control group.

  Conclusion  Transdermal fentanyl combined with gabapentin is effective for the treatment of malignant neuropathic pain.