Gabapentin provides effective postoperative analgesia whether administered pre-emptively or post-incision

Pandey, Chandra Kant; Singhal, Vinay; Kumar, Mukesh; Lakra, Archana; Ranjan, Rajeev; Pal, Rashmi; Raza, Mohsin; Singh, Uttam; Singh, Prabhat Kumar

doi:10.1007/bf03021777

Cited by 74 publications

(51 citation statements)

References 17 publications

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“…86 Three published postoperative trials have compared gabapentin to other drugs. Fassoulaki et al reported that analgesia and opioid sparing with gabapentin was comparable to that of the sodium channel blocker, mexiletine.…”

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confidence: 99%

Review article: The role of anticonvulsant drugs in postoperative pain management: a bench-to-bedside perspective

Gilron

2006

Can J Anesth/J Can Anesth

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Purpose: Anticonvulsant drugs are effective in the treatment of chronic neuropathic pain but were not, until recently, thought to be useful in more acute conditions such as postoperative pain. However, similar to nerve injury, surgical tissue injury is known to produce neuroplastic changes leading to spinal sensitization and the expression of stimulus-evoked hyperalgesia and allodynia. Pharmacological effects of anticonvulsant drugs which may be important in the modulation of these postoperative neural changes include suppression of sodium channel, calcium channel and glutamate receptor activity at peripheral, spinal and supraspinal sites. The purpose of this article is to review preclinical evidence and clinical trial data describing the efficacy and safety of anticonvulsant drugs in the setting of postoperative pain management. Source: A Medline search was performed to retrieve available literature on the basic and clinical pharmacology of anticonvulsant drugs as they pertain to postoperative pain management. Principal findings: Numerous laboratory studies have described analgesic effects of different anticonvulsant drugs in experimental pain models. Furthermore, several recent clinical trials have shown that anticonvulsants may reduce spontaneous and movement-evoked pain, as well as decrease opioid requirements postoperatively. Some early findings suggest further that anticonvulsant drugs may alleviate postoperative anxiety, accelerate postoperative functional recovery and reduce chronic postsurgical pain. Conclusion: Given the incomplete efficacy of currently available non-opioid analgesics, and the identified benefits of opioid sparing, anticonvulsant medications may be useful adjuncts for postoperative analgesia. Further research in this field is warranted. Objectif

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confidence: 99%

Review article: The role of anticonvulsant drugs in postoperative pain management: a bench-to-bedside perspective

Gilron

2006

Can J Anesth/J Can Anesth

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“…The total amount of morphine requirement on the 1st day in the gabapentin group was not different from the placebo. In a study by Pandey, both pre and post incision administration of gabapentin were equally effective in reducing postoperative pain in subjects undergoing open donor nephrectomy and both groups also consumed less fentanyl (26). There are 4 methodological differences between Pandey`s and the current study: 1 st , The dose of gabapentin was 600 mg but in the current study, it was 300 mg. 2 nd , The time points at which pain scores were recorded.…”

Section: Discussionmentioning

confidence: 58%

Postoperative Gabapentin to Prevent Postoperative Pain: A Randomized Clinical Trial

Khahi¹,

Marashi²,

Khajavi³

et al. 2012

anesthpain

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Gabapentin is an anticonvulsant that has postoperative analgesic effects but there have been limited studies on its postoperative administration. The present study was conducted to evaluate the effect of the postoperative oral gabapentin on pain and morphine consumption. The results indicated no significant analgesic efficacy of oral gabapentin 300 mg immediately after tibia internal fixation surgery under spinal anesthesia at time points of 2, 12 and 24 hours postoperatively. 4). Gabapentin has an analgesic (5) and opioid-sparing effect (1, 4, 6) both at rest and with movement (7) in acute postoperative pain management (1,(8)(9)(10)(11)(12)(13). Postoperative pain is not purely nociceptive and may have other (inflammatory and visceral) components (14); so using drugs that act on different analgesic mechanisms seems BackgroundNowadays, a variety of new drugs, devices, analgesic techniques and preventive approaches are available for anesthesiologists including patient-controlled analgesia, multimodal analgesia and pre-emptive analgesia (1-Background: Gabapentin is an anticonvulsant that has postoperative analgesic effects but there are limited studies on its postoperative administration. Objectives: The present study was conducted to evaluate the effect of the postoperative oral gabapentin on pain and morphine consumption. Patients and Methods:In a double blind, randomized study, 64 patients undergoing internal fixation of tibia under spinal anesthesia were randomly assigned to receive oral gabapentin or placebo immediately after the surgery. Pain scores were recorded at time points of 2, 12 and 24 hours postoperatively using visual analog scale (VAS). Time duration from the end of surgery until morphine administration and total morphine requirement in the first 24 hours were recorded. Results: The estimated duration of surgeries was 120-150 minutes. VAS score was not significantly different between the two groups at 2, 12 and 24 hours after surgery. There was no significant morphine consumption difference between the groups. Conclusions: Our study showed no significant analgesic efficacy of oral gabapentin 300 mg immediately after tibia internal fixation surgery under spinal anesthesia at time points of 2, 12 and 24 hours postoperatively.

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“…The findings are consistent with the studies 4,25,30 in which gabapentin was used in the dose of 1200mg, the same dose as used in our study. Pandey et al 29 and Giron et al 31 in their study reported a higher incidence of sedation in patients who received gabapentin. In the study by Gilron et al 31 17.4% of patients in gabapentin group developed heavy sedation compared to placebo group (P < 0.05).…”

Section: Discussionmentioning

confidence: 86%

“…Differences between results from our study can be attributed to difference in types of surgery and in use of different types of analgesics. Gabapentin has been reported to be more effective when given preoperatively however, Pandey et al 29 in their study reported that gabapentin (600mg), given preemptively or post incision did not have significant difference in fentanyl consumption between pre-and post-incision groups. However, our study has shown that gabapentin when given preoperatively has resulted in significant less morphine consumption.…”

Section: Discussionmentioning

confidence: 88%

Evaluation of the effect of gabapentin on postoperative analgesia with epidural morphine after abdominal hysterectomy

Aryal

Gurung

Marhatta

2017

J Coll Med Sci-Nepal

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Background & Objectives: Gabapentin has been used successfully as a non-opioid analgesic adjuvant for postoperative pain management. We hypothesized that the preoperative use of gabapentin prolonged the analgesic effect of epidural morphine without an increase in adverse effects of morphine. Materials & Methods: In a randomized, double blind study sixty ASA PS I and II patients undergoing abdominal hysterectomy were assigned to receive either placebo or gabapentin 1200mg 1 hour before surgery. Postoperatively, 0.125% bupivacaine with morphine 50 µg per kg body weight was used for epidural analgesia. Vital parameters, time to the first request for analgesic, visual analogue scale scoring for pain at rest and during movement, 24-hour morphine consumption, and side effects were studied.Results: The patients were comparable with respect to age, weight, ASA PS, baseline hemodynamic parameters and duration of surgery. Gabapentin significantly decreased the duration of analgesia compared to placebo (1078.26 min Vs. 303.5 min; P value <0.0001). The VAS scores at rest and during movement at 1, 2, 4, 8, 12, and 24h were significantly lower in gabapentin group. The total amount of morphine consumption in 24 h postoperatively was significantly lower in gabapentin group (1.93mg Vs. 6.30mg; P value <0.0001). The incidence of nausea and pruritus was significantly lower with gabapentin. Conclusion: Oral gabapentin 1200 mg as a premedication decreases the dose requirement of epidural morphine and postoperative pain after total abdominal hysterectomy. It also decreases the pain scores at rest and during movement significantly.

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Gabapentin provides effective postoperative analgesia whether administered pre-emptively or post-incision

Cited by 74 publications

References 17 publications

Review article: The role of anticonvulsant drugs in postoperative pain management: a bench-to-bedside perspective

Review article: The role of anticonvulsant drugs in postoperative pain management: a bench-to-bedside perspective

Postoperative Gabapentin to Prevent Postoperative Pain: A Randomized Clinical Trial

Evaluation of the effect of gabapentin on postoperative analgesia with epidural morphine after abdominal hysterectomy

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