Randomized controlled trial of two oral regimens of gabapentin versus placebo in patients for Cesarean section under spinal anesthesia regarding postoperative pain, sedation, nausea and vomiting

Hafez, M.; Abdel‐Hamid, Mona; Youssef, Maha Mahammed Ismail; Abdelrahim, Iman Kasban Hussien

doi:10.1016/j.egja.2016.10.010

Cited by 8 publications

(13 citation statements)

References 23 publications

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“…In the majority of the studies of the efficacy of clonidine, 51,97e99 gabapentin, 103e105,107 and ketamine described previously, 113e115 multimodal analgesia was used for post-Caesarean analgesia. One study of clonidine 96 and two studies of gabapentin 106,108 did not document whether other agents were used in their studies and were therefore of lower quality. Currently, there are few studies with mixed findings on the efficacy of perioperative analgesics on persistent pain after Caesarean delivery, and even less information regarding preventive measures of persistent pain after vaginal delivery.…”

Section: Possible Preventive Interventionsmentioning

confidence: 99%

Factors associated with persistent pain after childbirth: a narrative review

Komatsu

Ando

Flood

2020

British Journal of Anaesthesia

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A systematic literature search was performed to identify studies that reported risk factors for persistent pain after childbirth. Many studies have sought to identify risk factors for post-delivery pain in different populations, using different methodologies and different outcome variables. Studies of several different but interrelated post-partum pain syndromes have been conducted. Factors strongly and specifically associated with persistent incisional scar pain after Caesarean delivery include a coexisting persistent pain problem in another part of the body and severe acute postoperative pain. For persistent vaginal and perineal pain, operative vaginal delivery and the magnitude of perineal trauma have been consistently linked. History of pregnancy-related and pre-pregnancy back pain and heavier body weight are robust risk factors for persistent back pain after pregnancy. Unfortunately, limitations, particularly small samples and lack of a priori sample size calculation designed to detect specific effect sizes for risk of persistent pain outcomes, preclude definitive conclusions about many other predictors and the strength of outcome associations. In future studies, assessments of specific phenotypes using a rigorous analysis with appropriate predetermined sample sizes and validated instruments are needed to allow elucidation of stronger and reliable associations. Interventional studies targeting the most robustly associated, modifiable risk factors, such as acute post-partum pain, may lead to solutions for the prevention and treatment of these common problems that impact a large population.

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Section: Possible Preventive Interventionsmentioning

confidence: 99%

Factors associated with persistent pain after childbirth: a narrative review

Komatsu

Ando

Flood

2020

British Journal of Anaesthesia

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“…Untuk mengoptimalkan perawatan nyeri dan hasil pascabedah, analgesik baru dan kombinasi baru analgesik yang sudah ada terus dicari. 4,5 Gabapentin adalah obat dengan struktur kimia yang meniru neurotransmitter gamma amino butyric acid (GABA) dan bekerja pada reseptor otak yang sama. Namun, modus tindakannya tidak sepenuhnya dipahami.…”

Section: Pendahuluanunclassified

“…Obat ini telah diperkenalkan sebagai obat antiepilepsi, tetapi terbukti efektif dalam mengendalikan nyeri neuropatik. 4,6 Baru-baru ini, gabapentin telah digunakan untuk mengurangi kecemasan pra-operasi, nyeri akut pascabedah, kebutuhan opioid pascabedah, mualmuntah pascabedah, dan delirium. Kemanjuran dan keamanan gabapentin oral pra operasi pada nyeri dan konsumsi opioid diteliti pada pasien yang menjalani berbagai prosedur bedah sebagai total histerektomi abdominal, histerektomi vaginal, torakotomi, dan operasi tulang belakang tetapi kesimpulan tentang dosis optimal dan durasi pengobatan tidak dapat dibuat karena heterogenitas uji coba.…”

Section: Pendahuluanunclassified

“…Kemanjuran dan keamanan gabapentin oral pra operasi pada nyeri dan konsumsi opioid diteliti pada pasien yang menjalani berbagai prosedur bedah sebagai total histerektomi abdominal, histerektomi vaginal, torakotomi, dan operasi tulang belakang tetapi kesimpulan tentang dosis optimal dan durasi pengobatan tidak dapat dibuat karena heterogenitas uji coba. 4,7,8 Penelitian lainnya menilai efektivitas gabapentin 600 mg dan 900 mg per oral kombinasi ketorolak 30 mg/8 jam intravena sebagai analgesia pascabedah pada histerektomi total dengan anestesi umum didapatkan gabapentin 600 mg dengan gabapentin 900 mg kombinasi ketorolak 30 mg/8 jam sebagai analgesia pascabedah tidak berbeda efektivitasnya dalam mengurangi nilai visual analog scale (VAS) dan kebutuhan rescue analgesia petidin selama 24 jam pascabedah. 1 Karena gabapentin tampaknya mencegah nyeri nosiseptif dan inflamasi akut dan mungkin mengurangi nyeri pasca operasi, oleh karena itu penelitian ini bertujuan untuk membandingkan gabapentin oral 600 mg, 750 mg dan 900 mg pada operasi histerektomi total dengan anestesi spinal efeknya pada sedasi, mual-muntah, dan nyeri pascabedah.…”

Section: Pendahuluanunclassified

“…Penelitian lainnya tahun 2017 dengan membandingkan efek gabapentin oral 900 mg dengan 600 mg pada pasien yang menjalani seksio sesarea dengan anestesi spinal didapatkan bahwa gabapentin oral 900 mg lebih efektif daripada 600 mg dalam mengurangi nyeri pascabedah sesarea. 4 Pada penelitian tahun 2016 menilai efektivitas gabapentin 600 mg dan 900 mg per oral kombinasi ketorolak 30 mg/8 jam intravena sebagai analgesia pascabedah pada histerektomi total dengan anestesi umum didapatkan gabapentin 600 mg dengan gabapentin 900 mg kombinasi ketorolak 30 mg/8 jam sebagai analgesia pascabedah tidak berbeda efektivitasnya dalam mengurangi nilai VAS selama 24 jam pascabedah. 1 Penelitian farmakokinetik pada gabapentin menunjukkan bahwa absorbsi gabapentin sangat bergantung dosis obat.…”

Section: Pembahasanunclassified

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Perbandingan Tiga Dosis Gabapentin Oral terhadap Nyeri Pascabedah, Sedasi, dan Mual-Muntah pada Histerektomi Total dengan Anestesi Spinal

Ilhamsyah

Gaus²,

Muchtar³

et al. 2021

JAOI

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Latar Belakang: Gabapentin dapat mencegah nyeri nosiseptif, nyeri neuropatik, inflamasi akut dan mengurangi nyeri pasca operasi. Tujuan: penelitian ini membandingkan tiga dosis gabapentin oral pada operasi histerektomi total dengan anestesi spinal untuk efeknya pada sedasi, mual-muntah, dan nyeri pascabedahSubjek dan Metode: Desain yang digunakan pada penelitian ini adalah uji klinis acak tersamar tunggal. Sampel terbagi dalam kelompok G600: gabapentin 600 mg, kelompok G750 gabapentin 750 mg dan kelompok G900: gabapentin 900 mg dengan jumlah sampel masing-masing 14 orang. Data dianalisis menggunakan uji statistik uji Mann Whitney U.Hasil: Perbandingan analgesik tambahan pascabedah kelompok G600 membutuhkan lebih banyak analgesik tambahan dibanding kelompok G750 (p = 0,021) dan begitu juga untuk kelompok G750 dibanding kelompok G900(p = 0,004). Perbandingan kelompok G600 dan G750 untuk skor sedasi dan agitasi Richmond berbeda bermakna pada jam ke-3,6, dan 9 (nilai p 0,004; 0,007; dan 0,03) dan kelompok G600 dan G900 juga berbeda bermakna pada jam ke-3,6, dan 9 (p = 0,007). Untuk post operative nausea and vomiting (PONV) terdapat perbedaan bermakna antara kelompok G600 dan G900 dan juga antara kelompok G750 dan G900 (p = 0,043). Simpulan: Pemberian gabapentin oral 900 mg memberikan total rescue analgetik paling sedikit dibanding dengan pemberian gabapentin 600 mg dan 750 mg. Ketiga kelompok gabapentin mengalami efek samping sedasi ringan. Kejadian PONV paling rendah pada kelompok gabapentin 900 mg. Comparison Between Three Doses of Oral Gabapentin Against Postoperative Pain, Sedation, and Nausea-Vomiting in Total Hysterectomy with Spinal Anesthesia Abstract Background: Gabapentin can prevent nociceptive pain, neuropathic pain, acute inflammation and reduce postoperative painObjective: this study aimed to compare three doses of oral gabapentin in total hysterectomy with spinal anesthesia for its effect on sedation, postoperative nausea and vomiting, and post operative painSubject and Method: This study was a single blind randomized clinical trial. Samples were divided into groups of G600: gabapentin 600 mg, group G750 gabapentin 750 mg and group G900: gabapentin 900 mg with the number of samples was 14 people each. Data were analyzed using statistical analysis using the Mann Whitney U test.Results: Comparison of postoperative adjunctive analgesics in the G600 group required more additional analgesics than the G750 group (p = 0.021) and likewise for the G750 group compared to the G900 group (p = 0.004). Comparison of the G600 and G750 groups for sedation and agitation scores for Richmond was significantly different at the 3.6 and 9 hours (p value 0.004; 0.007; and 0.03) and the G600 and G900 groups were also significantly different at the 3.6 hour, and 9 (p = 0.007). For post operative nausea and vomiting (PONV), there were significant differences between the G600 and G900 groups and also between the G750 and G900 groups (p = 0.043).Conclusion: Gabapentin oral 900 mg with the least total analgesic rescue compared to gabapentin 600 mg and 750 mg. All three gabapentin groups experienced mild side effects of sedation. The lowest incidence of PONV was in the gabapentin 900 mg group

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Interventions for preventing nausea and vomiting in women undergoing regional anaesthesia for caesarean section

Griffiths

Gyte

Popham

et al. 2021

Cochrane Database of Systematic Reviews

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Randomized controlled trial of two oral regimens of gabapentin versus placebo in patients for Cesarean section under spinal anesthesia regarding postoperative pain, sedation, nausea and vomiting

Abstract: Abdelrahim (2017) Randomized controlled trial of two oral regimens of gabapentin versus placebo in patients for Cesarean section under spinal anesthesia regarding postoperative pain, sedation, nausea and vomiting,

Cited by 8 publications

References 23 publications

Factors associated with persistent pain after childbirth: a narrative review

Factors associated with persistent pain after childbirth: a narrative review

Perbandingan Tiga Dosis Gabapentin Oral terhadap Nyeri Pascabedah, Sedasi, dan Mual-Muntah pada Histerektomi Total dengan Anestesi Spinal

Interventions for preventing nausea and vomiting in women undergoing regional anaesthesia for caesarean section

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