The effects of gabapentin on acute and chronic pain after inguinal herniorraphy (original) (raw)
Related papers
Background and Aims: the aim of the study was to evaluate inguinal canal block together with intra-incisional injection of tramadol against bupivacaine 0.25% in cases undergoing inguinal hernioplasty under general anesthesia (GA). Methodology: In this randomized controlled trial, 120 male patients were chosen for this study with ASA I or II criteria, between 18 and 60 years of age. They were divided into three groups: either control (Group A), 0.25% bupivacaine (Group B), or tramadol (Group C). After induction of GA, the inguinal canal block and intraincisional infiltration were performed under ultrasound guidance, maintaining the heart rate (HR) and mean arterial blood pressure (MABP) within 20% of their values before induction by the use of Fentanyl bolus intraoperatively. The pain assessment was done postoperatively by visual analogue score (VAS), the time for the first analgesic requirement and the total amount of meperidine consumption was measured. The data analysis was carried out with unpaired Student's t‑test and Chi‑square test using software SPSS 22.0 version. Results: The fentanyl requirements intra‑operatively, the postoperative VAS and total dose of postoperatively meperidine consumption were statistically higher in control group compared to both other groups. But the total amount of meperidine consumption postoperatively was statistically lower in tramadol group compared with other groups. Conclusion: An improved intra-operative and postoperative pain was provided by locally infiltrated tramadol, together with reducing the need of post‑operative pain control agents with consequent beneficial reduction of narcotic side effects. ABSTRACT Citation: Wahdan AS, Seleem AAE. The effect of inguinal canal and intraincisional infiltration of tramadol versus bupivacaine 0.25% on postoperative pain relief in patients undergoing inguinal hernioplasty under general anesthesia. Anaesth Pain & Intensive Care 2017;21(3):317-322
The impact of preemptive ropivacaine in inguinal hernioplasty – A randomized controlled trial
International Journal of Surgery, 2015
h i g h l i g h t s Inhibition of the pain cycle through pre-emptive analgesia is under review now a days. Pre-emptive versus orthodox analgesia for postoperative pain control is still ambivalent. This study validates the effectiveness of pre-emptive analgesics. It considerably reduces postoperative pain. It is cost effective by decreasing the analgesic demand and shortening the hospital stay.
Clinical and Experimental Medical Sciences, 2013
Combined spinal-epidural anesthesia (CSEA) is a technique, which is frequently preferred in lower extremity surgery. It has been reported that preoperative administration of gabapentin, approved for neuropathic and chronic pains, also reduces postoperative pain. In this study, the effect of preoperative administration of gabapentin on postoperative pain in patients who had CSEA during lower extremity surgery is investigated. Material and Methods: After obtaining the approval of the Ethics Committee and the written consent, 60 patients (ages between 18-65 years) who were lower extremity surgery candidates and classified as ASA I-III, were included in the study. The patients were classified randomly into two groups. Group P (n=30) was given 0.5% levobupivacaine (10-15 mg) and fentanyl (25 μg) by spinal route. In the postoperative period, morphine (3 mg) was administered via epidural catheter after the spinal block has resolved. Group G (n=30) was administered 600 mg of gabapentin 1-2 hours prior to surgery, in addition to the medication of Group P. In the postoperative period, hemodynamic data (SAP, DAP, HR), pain scores (VAS), sedation scores, pruritus scores, other side effects (nausea, hypotension, respiratory depression, bradycardia), and the need for antihistaminic and additional analgesics were assessed. Results: The demographic characteristics, hemodynamic parameters, duration of surgery, and sedation scores of the groups were similar. It was found that the postoperative pain scores (VAS) were lower in group G at the 30 th and 60 th minutes and at 18 th and 24 th hours (p<0.05). In the postoperative period, 10 patients in Group P experienced pruritus at the 18 th hour, as did eight patients at the 24 th hour, whereas none of the patients in Group G reported pruritus at either the 18 th or 24 th hours (p<0.001, p<0.005). The differences between the nausea scores and other side effects of the two groups were not statistically significant. Conclusion: It was concluded that preoperative gabapentin statistically decreased postoperative pain levels as well as pruritus caused by opioids, but did not improve nausea in patients undergoing lower extremity surgery.
Electronic journal of general medicine, 2016
Background. Preemptive analgesia is an antinociceptive treatment that prevents establishment of altered processing of afferent input. Gabapentin, a structural analogue of gamma-amino butyric acid, has been used as an anticonvulsant and antinociceptive drug and is claimed to be more effective in preventing neuropathic component of acute nociceptive pain of surgery. Methods Fifty patients of ASA grade I and II were assigned to receive oral 600mg Gabapentin or Placebo 2 hours before surgery. Surgeries were conducted under spinal anesthesia. Post operatively pain was assessed by visual analogue score (VAS) at 2, 4, 8, 12 and 24 hrs. Patients were given rescue analgesic on demand. Sedation score and total numbers of analgesics during first 24 hours postoperatively were noted. Results. Gabapentin group resulted in faster onset of motor and sensory block, significantly longer duration of analgesia, substantial reduction in post-operative pain and the rescue analgesics. Patients remained in sleeping but cooperative state and Gabapentin group were not associated with side effects when compared with placebo group. Conclusions. Preemptive use of Gabapentin 600mg orally significantly prolongs the analgesia with reducing postoperative pain and rescue analgesics in patients undergoing total abdominal hysterectomy under spinal anesthesia.
Local anaesthesia in postoperative analgesia for herniorrhaphy
Ambulatory Surgery, 1996
Objective: 'To test the hypothesis that local infiltration with buptvacaine at the time of herniorrhaph>i would decrease postoperative pain. Design: Sixty-five patients in whom a polypropylene mesh was implanted to treat an inguinal hernia were included in a random double-blind study. Operative anaesthesia was intrddural with prilocaine 5%. 1.25 mgikg. After the procedure. an ilioinguinal and iliohypogastric block was performed by infiltration of soft tissues with 0.1'; n&kg of either bupivacaine 0.5% or NaCl 9 g/l. Postoperative pain was assessed with an analog pain scale, (range 0 5) in the recovery room. 8 h later and 24 h later. The patient assessed the pain 24 h after surgery (range O-5) and the relationship with the pain hr expected (range O-2). The time when the first dose of analgesia (diclofenac 75 mg i.v.) was given was also noted (range O-6). A score (range O-28) was calculated to quantify postoperative pain. Results: Thirty-three patients were infiltrated with bupivacaine and B2 patients received placebo. Both groups were similar in sex, age, weight and operating time (44 (20 min)). No pain vvas reported for bupivacaine (score 1.4 (0.9)) and minor pain for placebo (score 2.1 (1.0)) in the recovery room (P < 0.05). Further pain assessment was similar in both groups (scores range: 1 .I-1.5). The first dose of analgesia was administered 2-3 h postoperatively (score 4.4 (2.0)) in the placebo group and 4 to 5 h postoperatively (score 2.9 (2.4)) in the bupivacaine group (P < 0.05). The final postoperative pain score was 11.3 (3.9) in the placebo group and 9.2 (4.4) in the bupivacdine group (P < 0.05). Conclusions: Local infiltration of the abdominal wall with bupivacaine reduces immediate postoperative pain and delays the ;tdmmrstration oi postoperative analgesia.
Anesthesiology, 2015
Studies examining the efficacy of a single preoperative dose of gabapentin for analgesia after cesarean delivery (CD) have been inconclusive. The authors hypothesized that a perioperative course of gabapentin would improve analgesia after CD. This single-center, randomized, double-blind, placebo-controlled, parallel-group, superiority trial was designed to determine the analgesic efficacy of a perioperative course of gabapentin when added to a multimodal analgesic regimen. Women scheduled for elective CD during spinal anesthesia were randomized to receive a perioperative oral course of either gabapentin (600 mg preoperatively followed by 200 mg every 8 h for 2 days) or placebo. Postoperative pain was measured at 24 and 48 h, at rest and on movement, on a visual analogue scale (VAS, 0 to 100 mm). The primary outcome was pain on movement at 24 h. Neonatal outcomes, opiate consumption, VAS satisfaction (0 to 100 mm), adverse effects, and persistent pain were also assessed. Baseline cha...
Journal of College of Medical Sciences-nepal, 2017
Background & Objectives: Gabapentin has been used successfully as a non-opioid analgesic adjuvant for postoperative pain management. We hypothesized that the preoperative use of gabapentin prolonged the analgesic effect of epidural morphine without an increase in adverse effects of morphine. Materials & Methods: In a randomized, double blind study sixty ASA PS I and II patients undergoing abdominal hysterectomy were assigned to receive either placebo or gabapentin 1200mg 1 hour before surgery. Postoperatively, 0.125% bupivacaine with morphine 50 µg per kg body weight was used for epidural analgesia. Vital parameters, time to the first request for analgesic, visual analogue scale scoring for pain at rest and during movement, 24-hour morphine consumption, and side effects were studied. Results: The patients were comparable with respect to age, weight, ASA PS, baseline hemodynamic parameters and duration of surgery. Gabapentin significantly decreased the duration of analgesia compared to placebo (1078.26 min Vs. 303.5 min; P value <0.0001). The VAS scores at rest and during movement at 1, 2, 4, 8, 12, and 24h were significantly lower in gabapentin group. The total amount of morphine consumption in 24 h postoperatively was significantly lower in gabapentin group (1.93mg Vs. 6.30mg; P value <0.0001). The incidence of nausea and pruritus was significantly lower with gabapentin. Conclusion: Or al gabapentin 1200 mg as a pr emedication decr eases the dose requirement of epidural morphine and postoperative pain after total abdominal hysterectomy. It also decreases the pain scores at rest and during movement significantly.
Analogic evaluation of pain during inguinal hernioplasty under local anaesthesia
Annali italiani di chirurgia
The authors evaluate intraoperative pain in patients undergoing tension-free inguinal hernioplasty under local anaesthesia. One hundred and fourteen primary inguinal hernia repairs were carried out at the Department of General Surgery I of Catania University Polyclinic from January to September 2002. 2% Mepivacaine cloridrate was the local anesthetic of choice. Intraoperative pain was measured by a visual analog scale. A mean analogic score of 1.9 (range 0-2.9) was obtained. Intraoperative complications were recorded only in 2 patients (1.7%). There was no operative mortality. All patients were up and about straightaway after surgery, had a light meal two hours later and were discharged within one day of operation. Inguinal hernia repair under local anaesthesia is well tolerated and is associated with a low risk of complications.
American Journal of Therapeutics, 2017
Background: Preemptive use of gabapentin might accelerate recovery by reducing acute post-inguinal herniorrhaphy pain and opioid requirement being an analgesic. Study Question: Assessing efficacy of three different doses of oral gabapentin premedication for postoperative pain management after inguinal herniorrhaphy under spinal anesthesia. Study Design: This prospective, randomized, placebo controlled study was performed on 120 male patients (ASA I/II) undergoing inguinal herniorrhaphy under subarachnoid block. Patients were divided into 4 groups of 30 patients each to receive placebo (group A) or gabapentin 400 mg (B) or 800 mg (C) or 1200 mg (D), administered orally 2 hours before surgery. Assessment of postoperative pain was made on the basis of the visual analog score (VAS), where 0 cm "no pain" and 10 cm "worst pain imaginable." Patients received IV fentanyl 0.5 mg/kg bolus when VAS .3. Measures and Outcomes: VAS score at regular intervals, the first analgesic requirement and total opioid consumption within 24 hours after surgery along with side/adverse effect (s) of study drug in perioperative period. Results: The VAS of the study groups B, C, D were significantly lower than placebo group (A) at 0, 1, 2, 4, 8, 12, 16, 20, and 24-hour intervals after surgery (P , 0.05). The first analgesic need and total opioid consumption within 24 hours after surgery of study groups were significantly lower than placebo group (P , 0.005) while within study groups difference was not significant. Dizziness and somnolence were seen maximally in group D patients (P 5 0.01). However, pruritus, nausea and vomiting though maximally reported among group (A) patients but statistically non-significant.