Effects of Preoperative Gabapentin on Postoperative Nausea and Vomiting after Open Cholecystectomy: A Prospective Randomized Double-Blind Placebo-Controlled Study

Abstract

Objective: To evaluate the effect of gabapentin on the incidence and severity of postoperative nausea and vomiting (PONV) after open cholecystectomy. Subjects and Methods: A total of 90 patients scheduled for elective open cholecystectomy were randomly assigned to either a gabapentin group (600 mg, 2 h before surgery) or a placebo group. For the analysis, 1 patient was excluded from the gabapentin group and 2 patients from the placebo group. A standard technique was used for anesthesia. Pethidine and metoclopramide were used for postoperative management of pain and nausea/vomiting, respectively. The prevalence of PONV, its severity (measured on visual analogue scale, VAS), and total pethidine and metoclopramide use in the first 24 h after the operation were recorded. Results: There were no demographic differences between the two groups. Of the 44 patients given gabapentin, 16 (36.6%) and 28 of 43 (65.2%) placebo patients developed PONV; the difference was statistically significant (p = 0.02). However, there was no difference in the severity of PONV between the gabapentin and placebo groups (p = 0.12). Gabapentin patients used less pethidine (28.33 ± 129 mg) and metoclopramide (6.0 ±6.3 mg) than the placebo group (35.1 ± 15.1 and 9.33 ± 7.1 mg, respectively). The differences were statistically significant (pethidine: p = 0.002, metoclopramide: p = 0.033). However, gabapentin did not reduce postoperative pain significantly (p = 0.096). Conclusion: Our data show that gabapentin not only reduced PONV after open cholecystectomy, but also reduced the need for additional postoperative analgesics.

The Effect of Gabapentin Premedication on Postoperative Nausea, Vomiting, and Pain in Patients on Preoperative Dexamethasone Undergoing Craniotomy for Intracranial Tumors

“…A similar study in patients undergoing open cholecystectomy found a dose of 600 mg of oral gabapentin to be effective in reducing the incidence but not the severity of PONV. 27 The precise mechanism of antiemetic action of gabapentin remains speculative. It has been proposed that the drug may exert its action by virtue of tachykinin (NK-1) receptor antagonism and mitigation of tachykinin neurotransmitter (substance P) activity, which has been implicated in emetogensis.…”

Gabapentin in procedure-specific postoperative pain management – preplanned subgroup analyses from a systematic review with meta-analyses and trial sequential analyses

“…Eight trials were classified as overall low risk of bias, [39, 43, 46, 56, 59, 72, 73, 85] 18 trials were overall unclear risk of bias [21, 23, 24, 26, 28, 29, 31, 36, 38, 42, 52, 54, 55, 61, 65, 66, 68, 69, 80] and 48 trials were classified as high risk of bias, [20, 22, 25, 27, 30, 32–35, 37, 40, 41, 44, 45, 47–51, 53, 57, 58, 60, 62–64, 67, 70, 71, 74–79, 81–84, 86–94] (Fig. 2: Bias assessment).…”

“…[20, 22–24, 28–32, 34–37, 41, 43, 45, 47–51, 53, 55–57, 61–64, 67–71, 75, 77–79, 81, 82, 85–90, 92, 94] In 30 trials, gabapentin was administered in combination with a basic, non-opioid/opioid analgesic regimen [20, 22, 23, 26, 28, 30–32, 37–41, 43, 46, 49, 54, 56, 57, 59, 61, 72, 73, 76, 79, 80, 82, 87, 90, 91]. In 44 trials, gabapentin was administered together with an opioid as the only analgesic [20, 25, 27, 29, 33–36, 44, 45, 47, 48, 50–53, 55, 58, 62–71, 74, 75, 77, 78, 83–86, 88, 89, 92–94].…”

Enhanced Recovery Strategies in a Patient With Severe Pulmonary Hypertension

“…Ketamine was used intraoperatively, which can reduce post-operative cholecystectomy pain and continue to work as an adjuvant up to 24 hours after administration to reduce pain scores and opioid use [4]. Similarly, gabapentin and pregabalin have been shown to decrease post-operative pain and narcotic consumption requirements, which also reduces post-operative nausea and vomiting and associated mechanical pain [5,6].…”