Comparative clinical study of gabapentin and pregabalin for postoperative analgesia in laparoscopic cholecystectomy

Abstract

Background:Reduction in central sensitization by gabapentinoids that include gabapentin and pregabalin may reduce acute postoperative pain.Aims:The aim of this study is to evaluate postoperative analgesic benefit and efficacy in patients administered with oral gabapentin or pregabalin as premedication for laparoscopic cholecystectomy under general anesthesia.Settings and Design:Randomized, prospective, and comparative study.Materials and Methods:In this study, recruited patients were randomly allocated in three groups. Groups A, B, and C received 2 capsules of B complex, 3 capsules of 300 mg gabapentin each, and 2 capsules of 75 mg pregabalin, respectively, each in 30 patients of each group, 1 h before induction of anesthesia. Postoperative efficacy among these three groups was compared with respect to increase in duration of analgesia, reduction in postoperative pain scores, total postoperative requirements of analgesics and side effects.Statistical Analysis:Mean and standard deviation were calculated. Test of analysis between two groups was done by t-test and among three groups by analysis of variance, and then P value was calculated.Results:Pregabalin and gabapentin group had lower visual analog scale (VAS) score (P < 0.05), prolonged timing of first rescue analgesic (4.67 ± 14.79 vs. 158 ± 13.10 vs. 343.16 ± 9.69) min, and less opioid consumption (169.87 ± 20.32 vs. 116.13 ± 14.08 vs. 64.67 ± 16.69) mg compared to placebo group. Between the gabapentinoids, pregabalin group had lower VAS score, prolonged timing of first rescue analgesic, and less opioids consumption than the gabapentin group.Conclusion:It is concluded in this study that pregabalin group had lower VAS score, prolonged timing of first rescue analgesic, and less opioids consumption than the gabapentin group. Both gabapentinoids had better postoperative analgesic profile than placebo.

Dose-related beneficial and harmful effects of gabapentin in postoperative pain management &ndash; post hoc analyses from a systematic review with meta-analyses and trial sequential analyses

“…Treatment with gabapentin included both single-dose (84 trials) 9 , 12 , 25 – 29 , 31 – 36 , 40 – 45 , 47 , 49 – 52 , 56 , 58 , 59 , 61 , 63 , 65 – 67 , 69 – 73 , 75 – 78 , 82 – 86 , 88 , 90 – 94 , 96 , 97 , 99 , 102 – 106 , 109 , 111 – 118 , 120 – 122 , 124 , 125 , 128 – 131 , 133 , 136 , 138 , 139 , 143 and multiple-dose administration (38 trials). 5 , 30 , 37 – 39 , 46 , 48 , 53 – 55 , 57 , 60 , 62 , 68 ,…”

Pregabalin can decrease acute pain and morphine consumption in laparoscopic cholecystectomy patients

“…Two studies did not describe allocation concealment. [ 30 , 32 ] In addition, the risks of bias for blinding to the outcome assessment were unclear in 2 studies. [ 29 , 30 ] Thus, the overall quality of the included RCTs were high.…”

The efficacy of gabapentin in reducing pain intensity and postoperative nausea and vomiting following laparoscopic cholecystectomy

“…Finally, a total of 9 RCTs with 966 patients were included in this meta-analysis. [ 13 , 14 , 23 – 29 ]…”

“…[ 13 , 24 – 26 ] Blinding of participant and personnel was unclear in 4 studies, [ 14 , 27 – 29 ] and the rest all had low risk of bias. [ 13 , 23 – 26 ] We used Jadad score to assess the RCTs, and the results are displayed in Table 2 . The Jadad scores were 2 in 3 studies, 3 in 2 studies, and 5 in 4 studies.…”