The comparative preemptive analgesic efficacy of addition of vitamin B complex to gabapentin versus gabapentin alone in women undergoing cesarean section under spinal anesthesia

Abstract

Background:Development of new multimodal analgesic regimens have led to substantial improvement in postoperative pain relief. We designed this study to compare the effect of combined vitamin B complex—gabapentin versus gabapentin alone on postoperative pain in women undergoing cesarean section under spinal anesthesia.Methods:One hundred twenty-eight women who underwent cesarean section under spinal anesthesia were randomized to receive orally 300 mg gabapentin (group G) or 300 mg of gabapentin plus 2 vitamin B complex (group GB) tablets 30 minutes before surgery. Postoperative pain intensity and total analgesic consumption during 12 hours after surgery, vomiting, and drowsiness during recovery were assessed.Results:The pain intensity in the gabapentin plus vitamin B complex group was lower than gabapentin group during 12 hours after surgery (95% CI: 1.4–2.2; P < .001). Meanwhile, the total analgesic consumption in this group was less than gabapentin alone (95% CI: 1.07–1.24; P = 0.034). The incidence of vomiting in patients who receive combined gabapentin—vitamin B complex group was similar to gabapentin alone (P = .206). The difference of the distribution of the relative frequency of sedation according to Ramsay sedation scores in patients between 2 groups were insignificant (P = .82). All newborns in our study were free of any adverse effects.Conclusion:Addition of vitamin B complex to gabapentin reduced intensity of postoperative pain and also the total amount of analgesic consumption within the first 12 hours postoperative following cesarean section.

Efecto analgésico de la asociación de diclofenaco y vitaminas B1, B6 y B12 en cirugía de tercera molar.

“…Un probable motivo por el cual no encontraron una superioridad analgésica significativa para el grupo de diclofenaco más vitaminas B (como ha sido reportado en otras investigaciones), es que el número de administraciones y la dosis de vitamina B 12 fueron menores a las administradas en otras investigaciones. Reportaron también que el requerimiento de diclofenaco intravenoso postoperatorio fue significativamente menor en el grupo pretratado con diclofenaco más vitaminas B, lo cual sugiere que la administración preoperatoria de vitaminas B 1 , B 6 y B 12 puede reducir el consumo postoperatorio de AINE [15][16][17][18][19] .…”

PROSPECT guideline for elective caesarean section: updated systematic review and procedure‐specific postoperative pain management recommendations

“…In the two latter studies, basic analgesia consisted of diclofenac [21,22]. In a study conducted on patients who did not receive any basic analgesia, adding vitamin B complex to gabapentin reduced pain scores and opioid consumption compared with the use of gabapentin alone [23]. A systematic review reported a clinically significant reduction in 24-h pain scores with pre-operative gabapentin.…”

“…Four randomised controlled trials [20][21][22][23] and a metaanalysis [24] evaluated pre-operative gabapentinoids for analgesia after caesarean section. No significant benefits were reported with gabapentin when added to a multimodal analgesia regimen [20].…”

Perioperative analgesia after intrathecal fentanyl and morphine or morphine alone for cesarean section

“…Multimodal analgesia is established in the management of pain after cesarean section (CS), and different regimens are being tested. [ 1 ] However, the most popular strategies include intrathecal opioids, among which morphine, a hydrophilic opioid, is recognized as a gold standard. [ 2 ] It has been shown that morphine can provide postoperative analgesia for up to 24 hours, [ 3 ] and a dose of up to 100 μg is relatively safe in patients undergoing CS.…”