Abstract
Gabapentinis one of the adjuncts when given before surgery as a multi modal analgesia regimen has shown to decrease pain scores and opioid consumption in the first 24 hour after surgery. The aim of the study is to assess total opioid consumption in first 24 hour postoperatively after giving 600mg of preemptive oral Gabapentin in lower extremity orthopedic surgery done under subarachnoid block. A randomized single blinded study was conducted for duration of 6 months after approval from institutional review board. A total of 52 American Society of Anesthesiology physical status grade I and II cases were included in the study of which 26 patients received oral Gabapentin two hours prior to surgery and 26 patients in the control group. They were evaluated postoperatively for total opioid consumption in first 24 hours, Visual Analogue Score after 2, 4, 6 and 24 hours at rest. Total opioid consumption in first 24 hours was 74.13 ± 27.78 mg in Gabapentin group versus 123.53 ± 64.48 mg in Control (p = 0.001). VAS score was 1.23 ± 1.47 in Gabapentin group versus 2.12 ± 1.58 in Control group (p=0.04) at 2 hours and 2.19 ± 0.40 in Gabapentin group versus 2.77 ± 1.17 in control group (p=0.02) at 24 hours postoperatively at rest which were found to be statistically significant. Incidence of sedation was minimal and comparable in both groups. Oral Gabapentin 600mg given two hours before surgery reduces total opioid consumption in first 24 hours after surgery and also reduces Visual Analogue score for pain postoperatively at rest in 2 and 24 hours with minimum sedation.
Highlights
Gabapentin is one of the adjuncts when given before surgery as a multi modal analgesia regimen has shown to decrease pain scores and opioid consumption in the first 24 hour after surgery
Pre-emptive analgesia is a technique of pain control where treatment is initiated before intervention and operational during the surgical procedure in order to reduce the physiological consequences of nociceptive transmission provoked by the procedure.[1]
Hamal et al Efficacy of Preemptive Gabapentin for Lower Extremity Orthopedic Surgery Under Subarachnoid block channel is a binding site for Gabapentin at postsynaptic dorsal horn, which produces the antihyperalgesic effects by inhibiting neuronal calcium influx.[4]
Summary
Gabapentin is one of the adjuncts when given before surgery as a multi modal analgesia regimen has shown to decrease pain scores and opioid consumption in the first 24 hour after surgery. The aim of the study is to assess total opioid consumption in first 24 hour postoperatively after giving 600 mg of preemptive oral Gabapentin in lower extremity orthopedic surgery done under subarachnoid block. Hamal et al Efficacy of Preemptive Gabapentin for Lower Extremity Orthopedic Surgery Under Subarachnoid block channel is a binding site for Gabapentin at postsynaptic dorsal horn, which produces the antihyperalgesic effects by inhibiting neuronal calcium influx.[4] Owing to this protective effect on the nociceptive pathways, preemptive analgesia has the potential to be more effective and reduce postoperative pain and development of chronic pain. The purpose of the study is to evaluate the postoperative analgesic efficacy of preemptive oral Gabapentin prescribed two hours prior to lower extremity orthopedic surgery done under subarachnoid block
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