Gabapentin as an Adjunct to Perioperative Pain Management for Surgical Abortion: A Randomized Controlled Trial [10S

Abstract

INTRODUCTION: The use of gabapentin in the setting of surgical abortion has never been evaluated; however, it is used successfully in similar surgical settings as an adjunct to pain management. We sought to evaluate the impact of Gabapentin on perioperative pain during first trimester abortion with local anesthesia. METHODS: We conducted a randomized double-blinded placebo-controlled trial of gabapentin 600 mg given 1-2 hours pre-operatively among subjects receiving a 1st trimester surgical abortion under paracervical block. The primary outcome was pain on a 100-mm visual analog scale (VAS) measured at 6 time points perioperatively. To assess changes in pain measures, an intention to treat (ITT) mixed effects model was fit with treatment group (Gabapentin vs. Control) as a between-subjects factor and time point as a within-subjects factor plus their interaction term. Using Fisher's exact tests, we examined any group differences in the percentage of patients who reported side effects post procedure. RESULTS: Among the 115 randomized, most subjects were Black/African American (69.6%), average age was 26 years (+/-5.6), and mean gestational age was 61.8 days. There were no significant changes in pain score preoperatively or intraoperatively. Subjects who received gabapentin had significantly lower levels of pain at 10 minutes postsurgery [mean difference (SE) = -13.0 (-5.1), p-value = 0.01] and 30 minutes postsurgery [-10.5 (-5.1), p=0.04] as compared to subjects who received placebo. Side effects were rare, of low severity, with no significant difference between groups. CONCLUSION: Post-operative pain scores were lower among subjects receiving Gabapentin preoperatively compared to placebo, thus improving recovery.