Preemptive Use Of Gabapentin Research Articles

Effects of Gabapentin on Postoperative Pain and Total Analgesic Requirement After Laparoscopic Cholecystectomy

The aim of this study is to determine the effect of preoperative use of gabapentin on postoperative pain in patients undergoing laparoscopic cholecystectomy. Sixty adult patients listed for laparoscopic cholecystectomy were randomly allocated to two groups of 30 each to receive gabapentin 600 mg p.o. or a matching placebo 2 hours before surgery. Postoperative pain was monitored using 100 mm visual analogue scale (0 for no pain and 100 for worst imaginable pain) at 1, 2, 6, 12 and 24 hours. Diclofenac 75 mg IM was used as rescue analgesic and total analgesic requirement (mg/24hr) in first 24 hours following surgery was recorded. Postoperative pain scores and total analgesic requirement was significantly less in gabapentin group compared to placebo group. A single 600 mg dose of gabapentin given preoperatively decreased postoperative pain and total analgesic requirement following laparoscopic cholecystectomy. Preemptive use of gabapentin can be used to treat postoperative pain caused by laparoscopic cholecystectomy.

Role of Preemptive Gabapentin on Postoperative Analgesia After Infraumbilical Surgeries Under Subarachnoid Block-A Randomized, Placebo-Controlled, Double-Blind Study.

Preemptive use of gabapentin might accelerate recovery by reducing acute post-inguinal herniorrhaphy pain and opioid requirement being an analgesic. Assessing efficacy of three different doses of oral gabapentin premedication for postoperative pain management after inguinal herniorrhaphy under spinal anesthesia. 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 μg/kg bolus when VAS >3. 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. 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 = 0.01). However, pruritus, nausea and vomiting though maximally reported among group (A) patients but statistically non-significant. Preemptive gabapentin is opioid sparing to control postoperative pain with anxiolysis and sedation. We found the optimal dose to be 400 mg for gabapentin. However, increasing dose from 400 to 1200 mg does not increase its efficacy as analgesic but with higher adverse effects.

A Triple-Blind Randomized Trial of Preemptive Use of Gabapentin Before Laparoscopic Hysterectomy for Benign Gynaecologic Conditions.

This study sought to examine the efficacy of preemptive use of gabapentin in laparoscopic hysterectomy for benign gynaecologic conditions. In a triple-blind trial, the study investigators randomly assigned women undergoing laparoscopic hysterectomy to receive 600 mg gabapentin (n = 43) or placebo (n = 45) orally 1 hour before the procedure. Patient-controlled opioid analgesia was provided postoperatively. The primary outcome of the trial was cumulative opioid consumption in the first postoperative 24 hours. The study also assessed pain at rest and on movement, the presence of side effects, and patient satisfaction at 2, 8, and 24 hours after surgery. Between March 10, 2016 and May 1, 2018, 215 women were assessed for eligibility, 110 were randomized, and 88 completed the study. Enrolment was started after trial registration. The investigators found no difference in 24-hour cumulative morphine equivalent opioid consumption between the gabapentin group (26.9±14.7 mg) and the placebo group (27.1±15.1 mg). This provided a mean difference of 0.2 mg (95% CI -6.1 to 6.5, P=0.943). Pain scores at 2, 8, and 24 hours were also not found to differ between groups. Gabapentin was associated with increased dizziness, but it significantly reduced the use of antiemetic at any time in the first 24 postoperative hours. Patient satisfaction in the two groups was good and not found to differ. Preemptive administration of gabapentin before laparoscopic hysterectomy does not decrease postoperative pain scores and narcotic consumption.

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

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.

The Efficacy of Preoperative Gabapentin in Spinal Surgery: A Meta-Analysis of Randomized Controlled Trials

Background: Pain management after spinal surgery has been studied for years. Gabapentin is a third-generation antiepileptic drug that selectively affects the nociceptive process and has been used for pain relief after surgery. However, the relationship between gabapentin and postoperative pain in spinal surgery is still controversial. Objective: To assess the efficacy of the pre-emptive use of gabapentin in spinal surgery. Study Design: A meta-analysis of randomized controlled studies. Setting: The MEDLINE, EMBASE, ClinicalTrials.gov, and Web of Science databases were systematically searched. Methods: This meta-analysis of randomized controlled trials (RCTs) was performed to compare the use of gabapentin with placebo in spinal surgery regarding to the following: the mean difference (MD) of postoperative opioid requirements, the changes of visual analog scale (VAS) scores in 2 groups, and the incidence rate of adverse effects. An electronic-based search of all related literatures was conducted, and only RCTs for spinal surgery were included. The MD of postoperative opioid requirements and VAS scores and the relative risk (RR) of the incidence rate of adverse effects in the gabapentin group versus the placebo group were extracted throughout the study. Results: Ten trials, involving 827 patients, met the inclusion criteria and were included in this meta-analysis. The total morphine consumption was significantly lower over the first 24 hours postoperatively in the gabapentin group (P &lt; 0.05). The VAS scores at 2, 4, 6, 12, and 24 hours were less in the gabapentin group (P &lt; 0.05). The incidence rate of vomiting, pruritus, and urinary retention was significantly less in the gabapentin groups (RR = 0.53, 95% CI 0.32–0.86, P &lt; 0.05; RR = 0.38, 95% CI 0.22–0.66, P &lt; 0.05; RR = 0.57, 95% CI 0.34–0.98, P &lt; 0.05, respectively). Limitations: All of the studies we screened were published online except for unpublished articles. Only 10 RCTs met our inclusion criteria, so the sample size was still relatively small. Conclusion: This meta-analysis suggests that the administration of gabapentin is effective in reducing postoperative opioid consumption, VAS scores, and some side effects after spinal surgery. Key words: Gabapentin, analgesia, spinal surgery, meta-analysis, randomized controlled trials, visual analog scale score, side effect

The Effect of Gabapentin on Delayed Discharge from the Postanesthesia Care Unit: A Retrospective Analysis.

Enhanced recovery after surgery programs has incorporated gabapentin as part of a multimodal analgesia protocol. The preemptive use of gabapentin was found to be beneficial due to its opioid-sparing effect. However, excessive sedation and delayed discharge from postanesthesia recovery units are of concern. The aim of this study was to investigate whether preoperative gabapentin increased the length of stay in the recovery unit. This retrospective cross-sectional study was carried out over a period of 2 months in the postanesthesia care unit (PACU) of a tertiary care hospital in Canada. Two hundred and twenty-eight consecutive patients who underwent elective surgical procedures and who required a longer than 2-hour stay in the PACU were included. Prolonged stays caused by respiratory inadequacy, hemodynamic instability, nausea, vomiting, pain, and loss of consciousness were recorded. The data were collected from patients' charts and nursing flow sheets. All patients were grouped into those who received 300 mg gabapentin (n = 108), 600 mg gabapentin (n = 41), and no gabapentin (n = 139). No significant difference was observed between the groups in terms of opioid consumption, respiratory inadequacy, nausea, vomiting, and hemodynamic parameters. Gabapentin administration groups had significantly lower postoperative pain scores (P < 0.001). Decreased level of consciousness occurred significantly more often in a dose-dependent fashion in the gabapentin groups and led to a longer stay in the PACU (P < 0.001). In the setting of enhanced recovery after surgery, gabapentin did reduce pain scores, but at the cost of delayed discharge from the recovery room. Future studies are needed to evaluate the efficacy of gabapentin in this setting.

To evaluate the role of Gabapentin as preemptive analgesic in patients undergoing total abdominal hysterectomy in spinal anesthesia

Introduction: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.Material and 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 co- operative 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.

Preemptive Use of Gabapentin in Abdominal Hysterectomy

Preemptive Use of Gabapentin in Abdominal Hysterectomy

Preemptive use of gabapentin in abdominal hysterectomy: a systematic review and meta-analysis.

To examine the evidence of preemptive use of gabapentin in abdominal hysterectomy. We conducted an electronic based search using the following databases: PubMed, EMBASE, Ovid MEDLINE, ClinicalTrials.gov, and Cochrane Central Register of Controlled Trials. The following medical subject heading terms, keywords, and their combinations were used: "postoperative pain, hysterectomy, gynecologic surgical procedures, gabapentin, preemptive analgesia, and preemptive anesthesia." We manually searched the reference lists of identified studies. Randomized controlled trials of women who underwent a total abdominal hysterectomy, with or without bilateral salpingo-oophorectomy, under general anesthesia were examined. Only trials with preoperative dose of gabapentin were included. The meta-analysis and systematic review were performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Fourteen trials met the inclusion criteria. The pooled data consisted of 448 cases in the gabapentin group and 443 others in the control group. The 24-hour cumulative narcotic consumption and the visual analog scale scores at 24 hours postoperatively were used for postoperative pain assessment. There was a significant decrease in morphine consumption at 24 hours when gabapentin was administered before surgery (from 24.3-55.9 mg to 13.2-42.7 mg, standardized mean difference -0.69) as well before and after surgery (from 25.7-80 mg to 20.3-55 mg, standardized mean difference -1.45), respectively. Metaregression analysis showed that the effect of gabapentin in reducing morphine consumption (compared with placebo) at 24 hours was stronger in the preoperative only group than in the preoperative and postoperative groups. Preemptive gabapentin decreased visual analog scale from 9-42.7 to 2-25.3 (standardized mean difference -1.03, 95% confidence interval [CI] -1.36 to -0.71). Compared with the control group (16.1-96.7%), the rate of nausea was less in the gabapentin group (11.6-70%, relative risk 0.76, 95% CI 0.66-0.88). Preemptive administration of gabapentin is effective in decreasing postoperative pain scores, narcotic consumption, and nausea, and vomiting. I.

The effect of gabapentin versus intrathecal fentanyl on postoperative pain and morphine consumption in cesarean delivery: a prospective, randomized, double-blind study

Pain after cesarean delivery is a leading cause of chronic pain and there are many attempts to reduce it without total success. Gabapentin is effective in reducing acute and chronic pain with little experience in parturient. The purpose of this study is to compare the effect of pre-emptive gabapentin with intrathecal fentanyl on reducing postoperative pain and morphine consumption in cesarean surgery. Seventy-eight primiparous women who scheduled for non-emergency cesarean delivery were enrolled in the study and separated into two groups. The control group received 12.5 mg of heavy bupivacaine 0.5 % plus 10 μg of fentanyl intrathecally and the case group received 300 mg of gabapentin orally 2 h before surgery and 12.5 mg of heavy bupivacaine 0.5 % intrathecally. Data collection including blood pressure, heart rate, neonate sedation, Apgar score, visual analogous scale at several hours, at first, need to analgesic postoperatively. In the fentanyl group, the need for analgesic drug was earlier, total dose of morphine in 24 h and patient satisfaction was higher than the gabapentin group. The mean visual analogous scale at several hours postoperatively in the fentanyl groups was significantly higher than the gabapentin groups (P = 0.001). Preemptive use of gabapentin is a safe and effective way to reduce postoperative pain and morphine consumption in parturients after cesarean surgery.

A comparison of effect of preemptive use of oral gabapentin and pregabalin for acute post-operative pain after surgery under spinal anesthesia.

Background and Aims:Preemptive analgesia is an antinociceptive treatment that prevents establishment of altered processing of afferent input. Pregabalin has been claimed to be more effective in preventing neuropathic component of acute nociceptive pain of surgery. We conducted a study to compare the effect of oral gabapentin and pregabalin with control group for post-operative analgesiaMaterials and Methods:A total of 90 ASA grade I and II patients posted for elective gynecological surgeries were randomized into 3 groups (group A, B and C of 30 patients each). One hour before entering into the operation theatre the blinded drug selected for the study was given with a sip of water. Group A- received identical placebo capsule, Group B- received 600mg of gabapentin capsule and Group C — received 150 mg of pregabalin capsule. Spinal anesthesia was performed at L3-L4 interspace and a volume of 3.5 ml of 0.5% bupivacaine heavy injected over 30sec through a 25 G spinal needle. VAS score at first rescue analgesia, mean time of onset of analgesia, level of sensory block at 5min and 10 min interval, onset of motor block, total duration of analgesia and total requirement of rescue analgesia were observed as primary outcome. Hemodynamics and side effects were recorded as secondary outcome in all patients.Results:A significantly longer mean duration of effective analgesia in group C was observed compared with other groups (P < 0.001). The mean duration of effective analgesia in group C was 535.16 ± 32.86 min versus 151.83 ± 16.21 minutes in group A and 302.00 ± 24.26 minutes in group B. The mean numbers of doses of rescue analgesia in the first 24 hours in group A, B and C was 4.7 ± 0.65, 4.1 ±0.66 and 3.9±0.614. (P value <0.001).Conclusion:We conclude that preemptive use of gabapentin 600mg and pregabalin 150 mg orally significantly reduces the postoperative rescue analgesic requirement and increases the duration of postoperative analgesia in patients undergoing elective gynecological surgeries under spinal anesthesia

Pre-emptive use of Gabapentin for post-operative pain relief in upper abdominal surgeries

Background: Pain of upper abdominal surgeries not only distresses the patient but also results in inadequate respiratory efforts and cough reflex. So pain relief in these surgeries bears more significance than mere patient comfort. Gabapentine has been found effective for post-operative pain relief in many surgeries including spine surgeries, radical mastectomies etc. We carried out this study to find out the effectiveness of gabapentine for post-operative pain relief in upper abdominal surgeries. Materials and Methods: The present study was randomized, double-blind and prospective, designed to evaluate synergistic effect of gabapentine and total requirement of tramadol in various upper abdominal surgeries. The study was carried out in 50 patients of American Society of Anesthesiologists (ASA) grade I and II of either sex, aged between 20 to 60 years, divided into two groups of 25 patients each. Group P (placebo group) received oral placebo capsule (3 placebo capsule) and Group G (study group) received oral gabapentine capsule (1200 mg) (3 capsules of 400 mg each) pre-operatively 2 hrs before surgery. Patients were observed 24 hrs postoperatively for pain via visual analog scale (VAS), tramadol requirement (consumption) and side effects. Results: It was observed that patients in gabapentine group had statistically significant lower pain score at all time interval in comparison to placebo group. It was demonstrated that pre-emptive oral gabapentine significantly reduced tramadol consumption until 24 hrs post-operatively. Mild sedation was observed in gabapentine group but was comparable with Group P. Conclusion: Gabapentine significantly reduces post-operative pain and post-operative tramadol consumption in upper abdominal surgeries. Mild sedation was observed with gabapentine group but was comparable with placebo.

Effects of gabapentin on postoperative pain, nausea and vomiting after abdominal hysterectomy: a double blind randomized clinical trial

Gabapentin has demonstrated analgesic effects in some studies. This double blind randomized clinical trial (RCT) was conducted to evaluate whether the pre-emptive use of gabapentin 600 mg could reduce postoperative pain, nausea and vomiting, and meperidine consumption in patients after hysterectomy. Between 2009 and 2010, a total of 170 patients who were candidates for abdominal hysterectomy were assessed for eligibility to enter the study. Thirty patients were excluded for different reasons; and 140 included patients were randomly assigned to one of two groups according to the method of treatment, gabapentin or placebo, in a double-blind manner before hysterectomy. Postoperatively, the pain was assessed on a visual analogue scale (VAS) at 1, 4, 8, 12 and 24 h at rest. Meperidine intramuscularly was used to treat postoperative pain on VAS score and patients demand. Total meperidine and anti emetic drug consumption in the first 24 h after surgery was also recorded. The trial is registered at irct.ir, number IRCT201106186829N1. Patients in the gabapentin group had significantly lower VAS scores at all time intervals, than those in the placebo group. The total meperidine consumed in the gabapentin group was significantly less than in the placebo group. Postoperative nausea and vomiting (PONV) and anti emetic drug consumption were significantly decreased in gabapentin group. Pre-emptive use of gabapentin 600 mg orally, significantly decreases postoperative pain and PONV, and also rescues analgesic and anti emetic drug requirements in patients who undergo abdominal hysterectomy.

Does preemptive use of Gabapentin for postoperative analgesia attenuates the haemodynamic response to laryngoscopy and endotracheal intubation?

Kiskira, O.; Kolotoura, A.; Pouliou, A.; Vassilas, N.; Kirralidou, A.; Anastassiou, E. Author Information

Does Preemptive Use of Gabapentin Have No Effect on Postoperative Pain and Morphine Consumption Following Lumbar Laminectomy and Discetomy?

Does Preemptive Use of Gabapentin Have No Effect on Postoperative Pain and Morphine Consumption Following Lumbar Laminectomy and Discetomy?

Preemptive gabapentin decreases postoperative pain after lumbar discoidectomy

We investigated whether the preemptive use of gabapentin, a structural analogue of gamma amino butyric acid could reduce postoperative pain and fentanyl consumption in patients after single-level lumbar discoidectomy. Fifty-six ASA I and II patients were randomly allocated into two equal groups to receive either gabapentin 300 mg or placebo two hours before surgery. After surgery, the pain was assessed on a visual analogue scale (VAS) at intervals of 0-6, 6-12, 12-18, and 18-24 hr at rest. Total fentanyl consumption in the first 24 hr after surgery was also recorded. Fentanyl 2 mug.kg(-1) intravenously was used to treat postoperative pain on patients' demand. Patients in the gabapentin group had significantly lower VAS scores at all time intervals of 0-6, 6-12, 12-18, and 18-24 hr than those in the placebo group (3.5 +/- 2.3, 3.2 +/- 2.1, 1.8 +/- 1.7, 1.2 +/- 1.3 vs 6.1 +/- 1.7, 4.4 +/- 1.2, 3.3 +/- 1.1, 2.1 +/- 1.2; P < 0.05). The total fentanyl consumed after surgery in the first 24 hr in the gabapentin group (233.5 +/- 141.9, mean + SD) was significantly less than in the placebo group (359.6 +/- 104.1; P < 0.05). Preemptive gabapentin 300 mg po significantly decreases the severity of pain postoperatively in patients who undergo single-level lumbar discoidectomy.