Comparative Study between the Benefit of Pre-Emptive Pregabalin and Gabapentin on Acute Postoperative Pain for Elective Gynecological Surgery

Gamal A Abd Elhameed,Simon Armanios

doi:10.4236/ojanes.2019.912023

Abstract

Gabapentin, and pregabalin had been used in analgesic field some studies. This double blind randomized clinical trial was conducted to evaluate the pre-emptive use of gabapentin 900 mg and pregabalin 300 mg in reducing postoperative pain. Methods: A total number of 75 patients undergoing lower gynecological procedures were prospectively randomized, into three groups (group A, B and C), each group including 25 patients with total 75 patients. Pregabalin, gabapentin or placebo, the pain was assessed on a visual analogue scale (VAS) at 0, 6, 12, 18 & 24 hours postoperatively. Duration of effective analgesia was documented, and administration of extra analgesic doses of meperedine required in the first 24 hours. Results: Patients in the gabapentin or pregabalin had significantly lower VAS scores at 6, 12, 18 and 24 hours, than those in the placebo group. As for rescue analgesia with mepredine consumed in the gabapentin, and pregabalin were significantly less than in the placebo. As for the complications, both drugs had increased incidence of nausea, vomiting and dizziness postoperatively, while no significance was found between all groups as regard hypotension, bradycardia and shivering. Conclusion: Preoperative use of pregabalin or gabapentin provides comparable but significant prolonged postoperative analgesia, less nausea and vomiting compared to placebo after gynecological surgeries. However, it was associated with increased incidence of postoperative dizziness.

Highlights

IntroductionThe relief of postoperative pain is a subject of concern as it has been receiving an increasing amount of attention in the past few years [1], as failure to relieve pain is morally and ethically unacceptable
The relief of postoperative pain is a subject of concern as it has been receiving an increasing amount of attention in the past few years [1], as failure to relieve pain is morally and ethically unacceptable.The goals of pre-emptive analgesia are to decrease acute pain after tissue injury, and to inhibit the continuity of post-operative pain causing chronic pain [2]
Preoperative use of pregabalin or gabapentin provides comparable but significant prolonged postoperative analgesia, less nausea and vomiting compared to placebo after gynecological surgeries

Summary

Introduction

The relief of postoperative pain is a subject of concern as it has been receiving an increasing amount of attention in the past few years [1], as failure to relieve pain is morally and ethically unacceptable. The goals of pre-emptive analgesia are to decrease acute pain after tissue injury, and to inhibit the continuity of post-operative pain causing chronic pain [2]. Drugs such as local anesthetics injection, opioids, non-steroidal anti-inflammatory drugs, cyclooxygenase-2 inhibitor, paracetamol, gabapentin, pregabalin, clonidine and dexmedetomidine have been used as pre-emptive analgesics [3]. Antihyperalgesic drugs have shown improvement of postoperative pain by preventing the development of central sensitization. We compared the effect of preventive single dose of gabapentin or pregabalin on the acute postsurgical pain after elective lower abdomino-pelvic gynecological surgical procedures under spinal anesthesia, in order to neglect the possible analgesic effects of general anesthetics on the results of this study, to evaluate and compare the effect of the drugs on vital parameters, to study the post-operative requirement of analgesics and to compare the side effects of pregabalin and gabapentin

Methods

Discussion

Results

Conclusion