Gabapentin does not improve multimodal analgesia outcomes for total knee arthroplasty: a randomized controlled trial (original) (raw)

Pre-emptive gabapentin significantly reduces postoperative pain and morphine demand following lower extremity orthopaedic surgery

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...

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

Journal of Pain and Relief, 2019

Background: The aim of this study is to investigate the effect of a single dose of gabapentin, 1200 mg and one hour before surgery on postoperative pain in opioid-dependent patients undergoing lower extremity orthopedic surgeries. Methods: In this randomized double-blind clinical trial, 64 opioid-dependent patients, candidates of elective lower extremity orthopedic surgery at Chamran Hospital, Shiraz, Southern Iran, were recruited and randomly assigned to intervention (G)-1200 mg single oral dose of gabapentin an hour before surgery-and placebo (P) groups. Twenty four hour pain intensity (NRS) after surgery at 2, 4, 6, 12, 18, and 24 hour post-operative, time to the first request for analgesic and total amount of prescribed morphine were measured. The side effects of gabapentin and morphine were recorded at the mentioned time intervals. The patients' global satisfaction of the pain management was also assessed. Results: The patients in group G requested analgesic significantly later than the patients in group P (p=0.003). In the first postoperative hour group G received significantly lower amounts of morphine (p=0.038). Otherwise, no significant difference was detected between the two groups regarding the pain intensity and the amount of administered morphine. The frequency of drug-related side effects and the patients' global satisfaction were not significantly different in the two groups of the study. Conclusions: Oral gabapentin (1200 mg single bolus) can reduce the need for morphine and pain intensity only shortly (about an hour) after the operation in opioid-dependent patients undergoing orthopedic lower-extremity surgeries.

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.

The influence of pre- and perioperative administration of gabapentin on pain 3–4 years after total knee arthroplasty

Scandinavian Journal of Pain

Background and aims: Approximately 20% of patients having total knee arthroplasty (TKA) will experience chronic postoperative pain. Recently, preoperative pain facilitation has been associated with chronic pain after TKA, and gabapentin has been shown to decrease pain facilitation. The current study is a secondary follow-up of a primary RCT investigating the effect of gabapentin on acute postoperative pain after TKA and exploring the effect of pre- and perioperative administration of gabapentin on chronic postoperative pain and psychological state 3–4 years after TKA. Methods: Patients scheduled for TKA were randomized to either gabapentin 1,300 mg/day, gabapentin 900 mg/day, or placebo daily from 2-h before and 6 days after operation. Pre- and 3–4 years postoperatively pain scores related to pain while walking, at rest, when flexing the hip or the knee were collected. At the same time, the pain catastrophizing scale (PCS) and hospital anxiety and depression scale subscales for anxi...

Pre-Emptive Analgesia with Oral Gabapentin 300MG Given in the Morning of Surgery and Amount of Post Operative Analgesic Requirement

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.

Oral gabapentin for postoperative pain relief after lower limb surgery – a randomized controlled trail

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.

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 a pre-emptive analgesic in post-operative pain: a randomised double blind placebo controlled study

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...