"Protective Premedication": A comparative study of acetaminophen, gabapentin and combination of acetaminophen with gabapentin for post-operative analgesia

Syal, Kartik; Goma, Mandeep; Dogra, Ravi Kant; Ohri, Anil; Gupta, Ashok; Goel, Ashok K.

doi:10.4103/0970-9185.74604

Cited by 22 publications

(5 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Syal et al studied the combination of acetaminophen and gabapentin versus either agent alone given the morning of surgery. [15] Patients who consumed the combination regimen had lower visual analogue scale scores at all time intervals postoperatively. In addition, this was found to extend the time to opioid rescue following lower-extremity surgery.…”

Section: Peri-operative Phasementioning

confidence: 89%

Untitled

2023

HASSE

View full text Add to dashboard Cite

Section: Peri-operative Phasementioning

confidence: 89%

Untitled

2023

HASSE

View full text Add to dashboard Cite

“… 7 However, critical review of our study design focused on its failure to implement a 24- or 12-hour preload/preoperative dose of gabapentin and acetaminophen, as advocated for in the literature. 8 , 9 Additionally, our previous study solely examined a multimodal approach with acetaminophen, not recognizing the role nonsteroidal anti-inflammatory drugs (NSAIDs) play in postoperative pain management. Although NSAIDs are key instruments in pain management, surgeons have historically shied away from NSAID-based pain medications due to a theoretical risk of bleeding.…”

Section: Introductionmentioning

confidence: 99%

“…The gabapentin-based protocol incorporates the use of a preload of gabapentin with acetaminophen, as current literature indicates premedication and combination of acetaminophen with gabapentin is best practice to reduce postoperative pain scores and analgesic demands when prescribing gabapentin. 9 …”

Section: Introductionmentioning

confidence: 99%

A Comparison of Multimodal Analgesic Regimens for Opioid Reduction in Elective Plastic Surgery: A Randomized Study

Long-Lijoi,

Mukherjee,

Pinell

et al. 2023

Plastic and Reconstructive Surgery - Global Open

View full text Add to dashboard Cite

Background: This trial aimed to compare the efficacy of a multimodal analgesic regimen with gabapentin to a multimodal nonsteroidal anti-inflammatory drug (NSAID) regimen following cosmetic surgery. This was a prospective randomized study of 106 patients undergoing elective outpatient cosmetic surgery. Methods: Patients were randomly assigned to a multimodal regimen of postoperative acetaminophen, gabapentin, and oxycodone with an acetaminophen and gabapentin preload or postoperative ibuprofen and oxycodone-acetaminophen protocol without a preload. Data on compliance, number of narcotic pills consumed, duration of analgesic use, pain levels, patient satisfaction, time from incision close to postanesthesia care unit (PACU) admission, and incidence of bleeding-related complications were collected and analyzed. Results: Patients from both regimens reported equivalent postoperative pain control with the exception of pain in PACU. NSAID patients exhibited a 9.3% higher rate of compliance (P = 0.01), a 6.0% higher rate of satisfaction with pain control (P = 0.04), a 25.2% shorter interval between closure and PACU (=0.01), and an 8.2% lower rate of bleeding-related complications, all of which were statistically significant (P < 0.05). Conclusions: Both regimens are viable tools in combating opioid overprescription as they both effectively reduce postoperative pain. However, the NSAID protocol resulted in greater satisfaction related to pain management and was more cost-effective by reducing emergence time from anesthesia. As there were no hematomas associated with the use of NSAIDs and a significantly higher rate of compliance, the use of NSAIDs in enhanced recovery after surgery protocols is supported.

show abstract

“…Surgery causes tissue injury, resulting in the production of inflammatory mediators that stimulate pain receptors. These stimuli from tissue injury are transmitted by peripheral nociceptors to the spinal cord and higher centers, giving rise to the perception and affective component of pain [5]. After the surgical incision, central sensitization and hyperexcitability may develop, amplifying postoperative pain and potentially leading to adverse postoperative outcomes [6].…”

Section: Introductionmentioning

confidence: 99%

Analgesic Efficacy of Pre-operative Pregabalin in Dacryocystorhinostomy Surgery: A Systematic Review and Meta-Analysis of Randomized Placebo-Controlled Trials

Alhajaji,

Alshamrani,

Jalal

et al. 2023

Cureus

View full text Add to dashboard Cite

Dacryocystorhinostomy (DCR) is an effective surgical procedure for addressing lacrimal drainage problems. However, it can be a painful operation that involves incisions both inside and outside the eye, often leading to a high incidence of postoperative nausea and vomiting. Preemptive analgesics can be employed to alleviate this unrelieved pain. Nonetheless, many of the drugs used can induce a wide range of adverse effects. Therefore, the aim of this systematic review and meta-analysis is to assess the current evidence regarding the efficacy of pregabalin in managing postoperative pain following DCR surgery. We conducted a thorough search of five electronic databases, namely, PubMed, Web of Science, Scopus, Cochrane, and Google Scholar, to identify relevant randomized controlled trials (RCTs) published before September 2023. The quality of the included studies was assessed using the Cochrane Risk of Bias tool for RCTs. The outcomes we evaluated included postoperative pain, surgery duration, time to first analgesia, total pethidine consumption, and postoperative nausea and vomiting (PONV). Continues data reported as mean difference (MD), and dichotomous data reported as risk ratio (RR), with 95% confidence interval (CI). A pooled metaanalysis of three RCTs, including 240 patients in both the pregabalin and placebo groups, was conducted. The results revealed that the pooled MD in pain scores was significantly lower in patients treated with pregabalin compared to those receiving a placebo ((MD = -1.35 (95% CI: -1.83 to -0.87, p < 0.00001)). Additionally, the pooled MD of pethidine consumption was significantly lower in patients treated with pregabalin compared to those receiving a placebo (MD = -54.13 (95% CI: -103.77 to -4.50, p = 0.03)). However, there was no statistical significance between both groups in terms of time to first analgesia and duration of surgery (p > 0.05). On the other hand, the pooled RR of PONV was significantly lower in patients treated with pregabalin compared to those receiving a placebo (RR = 0.37 (95% CI: 0.24-0.57, p < 0.001)). This meta-analysis demonstrates that pregabalin is an effective and well-tolerated intervention for reducing postoperative pain and PONV following DCR surgery, without significantly affecting surgery duration or time to first analgesia. These findings support the use of pregabalin in improving patient comfort and outcomes in this surgical context.

show abstract

"Protective Premedication": A comparative study of acetaminophen, gabapentin and combination of acetaminophen with gabapentin for post-operative analgesia

Cited by 22 publications

References 0 publications

Untitled

Untitled

A Comparison of Multimodal Analgesic Regimens for Opioid Reduction in Elective Plastic Surgery: A Randomized Study

Analgesic Efficacy of Pre-operative Pregabalin in Dacryocystorhinostomy Surgery: A Systematic Review and Meta-Analysis of Randomized Placebo-Controlled Trials

Contact Info

Product

Resources

About