Effect of Pre-operative Oral Gabapentin on Postoperative Pain in Opioiddependent Patients Undergoing Orthopedic Surgeries of the Lower Extremity: A Randomized Double-blind Placebo-controlled Trial (original) (raw)
Related papers
Singapore medical journal, 2007
Gabapentin has demonstrated analgesic effects in clinical trials as a preemptive analgesic and in acute postoperative pain management. This study was conducted to evaluate whether the pre-emptive use of gabapentin could reduce postoperative pain and morphine consumption in patients after lower extremity orthopaedic surgery. 70 ASA I and II patients were randomly assigned to receive 300 mg gabapentin or placebo in a double-blind manner two hours before surgery under general anaesthesia. Postoperatively, the pain was assessed on a visual analogue scale (VAS) at 2, 4, 12, and 24 hours at rest. Morphine 0.05 mg/kg intravenously was used to treat postoperative pain on patients' demand. Total morphine consumption in the first 24 hours after surgery was also recorded. Patients in the gabapentin group had significantly lower VAS scores at all time intervals of 2, 4, 12, and 24 hours, than those in the placebo group (respectively, 55.50 [mean] +/- 15.80 [standard deviation], 57.30 +/- 19...
innovative publication
Introduction: In addition to anticonvulsant property of gabapentin, it was demonstrated that gabapentin also possesses analgesic property. In this randomized control trial the efficacy of gabapentin for postoperative pain relief was studied on 60 adult patients of either sex, belonging to ASA grade I or II, in the age range of 18-60 years posted for lower limb surgeries under spinal analgesia. Methods: The patients were randomly divided into two groups of 30 patients each. Group A patients (n=30) received oral gabapentin 1200 mg 2 hours prior to scheduled surgery and the same dose was given at 9:00 am on the first and second postoperative days. Group B (n=30) served as control group received only placebo capsules. Subarachnoid block was established in both the groups by administering 4 ml of hyperbaric bupivacaine. Vital parameters such as heart rate, blood pressure respiratory rate along with pain assessment (VAS) were recorded at regular intervals in the postoperative period. Rescue analgesia was provided with intramuscular butorphanol. Results: It was observed that patients in group A exhibited excellent quality of postoperative pain relief as compared to group B (P<0.0001). The requirement of opioids in the form of butorphanol was greatly reduced in group A as compared to group B (P<0.0001). Patient satisfaction using verbal rating scale was higher in Group A as compared to group B (P<0.0001). Minor side effects encountered were mild sedation, shivering, nausea, vomiting and dizziness which showed no significant difference between the groups. Conclusion: Oral administration of gabapentin holds great promise for excellent postoperative pain relief and reduction in the overall requirement of opioids without producing significant side effects.
Postoperative Gabapentin to Prevent Postoperative Pain: A Randomized Clinical Trial
Anesthesiology and Pain Medicine, 2012
Gabapentin is an anticonvulsant that has postoperative analgesic effects but there have been limited studies on its postoperative administration. The present study was conducted to evaluate the effect of the postoperative oral gabapentin on pain and morphine consumption. The results indicated no significant analgesic efficacy of oral gabapentin 300 mg immediately after tibia internal fixation surgery under spinal anesthesia at time points of 2, 12 and 24 hours postoperatively.
Canadian Journal of Anesthesia/Journal canadien d'anesthésie, 2013
This study assessed whether gabapentin given preoperatively and for two days postoperatively (in addition to patient-controlled analgesia [PCA] morphine, acetaminophen, and ketorolac) is effective in reducing morphine requirements and moderating pain scores when compared with placebo for primary total knee arthroplasty. Methods This single-centre double-blind randomized controlled trial was undertaken in patients who underwent primary total knee arthroplasty. All subjects received acetaminophen 1,000 mg and ketorolac 15 mg po preoperatively. Postoperatively, subjects received PCA morphine, acetaminophen 1,000 mg every six hours, and ketorolac 15 mg po every six hours. Subjects received either gabapentin 600 mg po preoperatively followed by 200 mg po every eight hours for two days or matching placebo. The primary outcome was cumulative morphine consumption at 72 hr following surgery. Secondary outcome measures included pain scores and patient satisfaction. Results There were 52 subjects in the gabapentin group and 49 subjects in the placebo group. The average cumulative morphine consumption at 72 hr postoperatively was 66.3 mg in the gabapentin group and 72.5 mg in the placebo group (difference-6.2 mg; 95% confidence interval-29.1 to 16.8 mg; P = 0.59). Mean pain scores at rest, with passive movement, or with weight bearing were similar in both groups at corresponding time periods for the first three days following surgery. In addition, mean patient satisfaction scores and hospital length of stay were similar in the two groups. Conclusion Gabapentin 600 mg po given preoperatively followed by 200 mg po every eight hours for two days has no effect on postoperative morphine consumption, pain
PARIPEX INDIAN JOURNAL OF RESEARCH, 2023
The study was done to evaluate postoperative benefit in patients administered tablet gabapentin as premedication with primary outcome determining the total analgesic requirements. The duration of analgesia and postoperative sedation scores were secondary outcomes. The study was a prospective randomised observational study in 120 patients undergoing spinal anaesthesia. Patients were randomly assigned into two groups. Group G (n=60) patients received tablet gabapentin 300mg and Group P (n=60) patients received a placebo orally 2 hours before surgery. Postoperative pain was managed with IV Tramadol 2 mg/kg. Postoperative monitoring included pain assessment with NRS and sedation score every 2 hours till 12 hours and then at 24 hours. On comparison, the total opioid requirement was not significant (p value 0.250) between the two groups but the duration of analgesia was significant (0.03) with group G. Sedation scores were higher in Group G at 2 and 4 hours postoperatively. Single dose of 300mg Gabapentin has no effect in reducing the postoperative opioid consumption but has prolonged the duration of analgesia.
International Journal of Basic & Clinical Pharmacology
Background: Conventional analgesics, used in peri-operative period cause numerous adverse effects and are not free from interactions with co-administered drugs. Gabapentin has been shown to be effective in various types of neuropathic pain. The primary aim of this study was to evaluate gabapentin as a post-operative analgesic. The study also evaluates the analgesic requirement and safety of gabapentin in post-operative period.Methods: Forty patients undergoing elective laparoscopic cholecystectomy were randomized to receive gabapentin or a matching placebo. The patients of group I received gabapentin 600mg orally 2 hrs before surgery and 12hrs after the first dose. The patients in group II received a matching placebo. Patients in both groups received diclofenac sodium 75mg i.m b.i.d for pain. Additional doses were given on demand and recorded.Results: The present study found that gabapentin significantly reduced pain score and analgesic consumption as compared to a placebo for a per...
Journal of Kathmandu Medical College
Background: Postoperative pain is a major cause of perioperative morbidity and functional impairment. Preemptive analgesia is an analgesia regimen instituted before the surgery, to desensitize the pain pathways. Pregabalin and gabapentin have been claimed to be effective in reducing postoperative pain without significant alterations in hemodynamics. Objectives: This study was conducted to compare the effectiveness of pregabalin and gabapentin in reducing postoperative pain, total opioid consumption, postoperative nausea and vomiting and sedation in patients undergoing lower limb orthopaedic surgeries under spinal anaesthesia. Methodology: Eighty patients undergoing lower limb orthopaedic surgeries under spinal anaesthesia were divided into two groups, to either receive 300mg gabapentin or 150mg pregabalin, one hour before surgery. The patients were evaluated at one, two, six, 12 and 24 hours postoperatively and Visual Analogue Scale score for pain, postoperative nausea vomiting, and...
Effectiveness and Safety of Gabapentin in the Management of Post-Operative Pain
Journal of Postgraduate Medical Institute, 2018
Objective: To determine the effectiveness and safety of preoperative gabapen- tin administration on post-operative pain after laparoscopic cholecystectomy. Methodology: Ninety patients undergoing laparoscopic cholecystectomy were divided into two groups. Group A received gabapentin in a dose of 300 mg two hours before surgery; and group B received placebo capsules in the same size and shape as gabapentin capsules. The pain scores, consumption of analgesics and adverse effects were compared between the two groups postoperatively at 2 hours, 6 hours, 12 hours and 24 hours after recovery. Results: Group A had statistically less pain scores as compared to group B at 2, 6, 12 and 24 hours after recovery (p values were 0.0001, <0.0001, 0.0004, <0.0001 respectively). The requirement of analgesics was statistically lower in group A in comparison to group B at all the time intervals (p <0.0001). Both groups had no difference in the frequency of adverse effects except for vomit- ing ...
Gabapentin for acute and chronic post-surgical pain
2007
Pain after surgery remains a significant clinical problem as it impairs recovery adversely and may lead to the transition to chronic pain. Opioid medications are far from ideal agents in suppressing postoperative pain. Gabapentin-an anticonvulsant with antihyperalgesic properties-originally efficacious against neuropathic pain seems to be very promising for the management of pain after surgery as well. Gabapentin, by decreasing noxious stimulus-induced excitatory neurotransmitter release at the spinal cord, may attenuate central sensitization, and eventually decrease postoperative late pain. Furthermore, different sites of action may be pertinent to a synergistic effect with opioids. Both actions (antihyperalgesic effect and synergy with opioid analgesia) may manifest as analgesia and/or opioid-sparing effect after surgery. This has been confirmed by a variety of clinical studies, in a variety of settings. Most of these studies have shown that either single preoperative or repeated doses of gabapentin, continued for up to a few days after surgery, decrease acute postoperative pain and/or need for postoperative opioids. This has been shown for procedures such as abdominal and vaginal hysterectomy, breast surgery for cancer (mastectomy or lumpectomy), lumbar discectomy and spinal fusion, laparoscopic cholecystectomy and other, such as ENT surgery. Finally, a few studies indicate that perioperative gabapentin may as well decrease chronic pain several weeks after surgery.