The Analgesic Effects of Gabapentin after Total Abdominal Hysterectomy

Document Type : Original Article

Authors

1 Assistant Professor of Obstetrics and Gynecology, Faculty of Medicine, Gilan University of Medical Sciences, Gilan, Iran.

2 Resident of Obstetrics and Gynecology, Faculty of Medicine, Gilan University of Medical Sciences, Gilan, Iran

3 Resident of Anesthetics, Faculty of Medicine, Gilan University of Medical Sciences, Gilan, Iran.

4 M.Sc. of Statistics, Faculty of Medicine, Gilan University of Medical Sciences, Gilan, Iran.

5 Medical Student, Faculty of Medicine, Gilan University of Medical Sciences, Gilan, Iran.

6 General Practitioner, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Introduction: Postoperative pain is a major problem in general surgery which can severely effect on patient. Studies have shown that gabapantin can produce analgesia and reduce the need for opioids in postoperative patients. In this study the efficacy of gabapantin were studied as a premedication for reduce pain and need for opioids in abdominal hysterectomy.
Methods: This double-blind clinical trial was performed in Alzahra maternity of Rasht in 2011. 60 patients who undergo elective abdominal hysterectomy randomly were divided into gabapantin group (1200mg) and placebo group (capsule like gabapantin). Patients visited immediately after recovery and on second and forth hours after surgery in recovery room and VAS was recorded. Data were analyzed with SPSS version 16 by t-student and Mann-Whitney tests.
Results: Age and surgery duration were matched in both groups. VAS was significantly difference in two groups for each of 3 visiting times (p=0.0001). Also the need for petidine was significantly more in control group than case group (p=0.0001).
Conclusion: Administration of gabapantin can reduce postoperative pain and improve sedation after surgery. Gabapantin as a premedication can also reduce need for opioids prescription.

Keywords


  1. Pandey ck, Singhal v et al . Gabapentin provide effective postoperative analgesia wheder administrative pre emptive or post-incision. Canadian Journal of Anaesthesia 52(8):827-31,2005
  2. Durmus A, Kadir But V et al. The post-operative analgesic effects of a combination of gabapentin and paracetamol in patients undergoing abdominal hysterectomy. Acta Anaesthesiol Scand 51:299-304,2007 .
  3. Rawal N, Berggren L.Organization of acute pain services:a low cost model. pain 57:117-23,1994 .
  4. Dickenson AH. Neurophysiology of opioid poorly responsive pain.Cancer Surv 21:5-16,1994 .
  5. Turan A, Karamanliglu B, Memis D et al.The analgesic effects off gabapentin after total abdominal hysterectomy. Anesth Analg 98:1370-3,2004 .
  6. Magnus L. Nonepileptic uses of gabapentin. Epilepsia 40(Suppl.6):66-72,1999 .
  7. Bertram G. Katzung. Basic and clinical pharmacology 8th ed. 5:563-564 .
  8. Dahl JB, Mathiesen O, Moiniche S.protective premedication: an option with gabapentin and related drugs. A review of gabapentin and pregabalin in the treatment of post operative pain. Acta Anaesthesiol Scand 48:1130-6,2004 .
  9. Seib RK, Paul JE. Preoperative gabapentin for postoperative analgesia; a meta-analysis. Can J Anaesth 53:461- 9,2006 .
  10. Mathiesen O, Møiniche S, Dahl JB. Gabapentin and postoperative pain: a qualitative and quantitative systematic review, with focus on procedure. BMC Anesthesiol. 2007; 7(6) :1-15 .
  11. Kehlet H, Dahl JB: Anaesthesia, surgery, and challenges in post-perative recovery. The Lancet 2003, 362:1921-28 .
  12. Sekhavat L , Zare F , Mojibian M. The Post Operative analgesic effects of low dose Gabapentin in patients undergoing Abdominal Hysterectomy . SAJOG 2009; 15(1): 37-40 .
  13. Turan A. White PF gabapentin : an alternative to cyclooxigenase-2 inhibitors for perioperative pain management . Anesth Analg 102:175-81,2006 .
  14. Dierking G, Duedahl T.H et el. Effects of gabapentin on post operative morphine consumption and pain after abdominal hysterectomy. Acta Anaesthesiol Scand 48:322-327,2004 .
  15. Sen H, Sizlan A, Yanarates O, Emirkadi H, Ozkan S, Dagli G, Turan A. A comparison of gabapentin and ketamine in acute and chronic pain after hysterectomy. Anesth Analg. 2009;109(5):1645-50 .
  16. Gilron I, Orr E, Tu D, Mercer CD, Bond D. A randomized, double-blind, controlled trial of perioperative administration of gabapentin, meloxicam and their combination for spontaneous and movement-evoked pain after ambulatory laparoscopic cholecystectomy. Anesth Analg. 2009;108(2):623-30 .
  17. Fassoulaki A, Stamatakis E, Petropoulos G, Siafaka I, Hassiakos D, Sarantopoulos C. Gabapentin attenuates late but not acute pain after abdominal hysterectomy. Eur J Anaesthesiol. 2006;23(2):136-41 .
  18. Dirks j , Fredensborg BB , Christensen D , Fomsgaard JS , Fliger H , Dahl JB . A Randomized study of the effects of single dose Gabapentin versus placebo on postoperative pain and morphine consumption after mastectomy . Anesthesiology 2002 ; 97: 560-4 .
  19. Pandey CK , Priye S , Singh S , Singh U , Singh RB , Singh PK . Preemptive use of Gabapentin significantly decreases post operative pain and resque analgesic requirements in Laparoscopic cholecystectomy . Can J Anesth 2004 ; 51 : 358-63 .
  20. Frederic Adam, Daniel I. Sessler, Marcel Chauvin. A single preoperative dose of gabapentin (800mg) does not agument postoperative analgesia in patient, given interscalene brachial plexus blocks for arthroscopic shoulder surgery. Department of Anasthesia. 103:1278-82,2006 .
  21. Bartholdy J, Hilsted KL, Hjortso NC, Engbaek J, Dahl JB: Effect of gabapentin on morphine demand and pain after laparoscopic sterilization using Filshie clips. A double blind randomized clinical trial. BMC Anesthesiol 2006, 6(12):36-45 .
  22. DirksJ , Moiniche S , Hilsted KL , Dahl JB . Mechanisms of post operative pain : clinical indications for acontribution of central neuronal sensitization . Anesthesiology 2002 ; 97:1591–6 .
  23. Eckhardt K ,Ammon S , Hofman U . Gabapentin enhances the analgesic effect of morphine in healthy volunteers . Anesth Analg 2000 ; 91 : 185–91 .
  24. Rorarius MG , Mennander S , Suominen P , Rintala S , Puura A , Pirhonen R , et al . Gabapentin for the prevention of postoperative pain after vaginal hysterectomy. Pain. 2004 ; 110 (1-2) : 175-81 .
  25. Durmus M , Kadir But A , Saricicek V , Ilksen Toprak H , Ozcan Ersoy M . The post-operative analgesic effects of a combination of gabapentin and paracetamol in patients undergoing abdominal hysterectomy: a randomized clinical trial. Acta Anaesthesiol Scand. 2007;51(3):299-304.
  26. Tuncer S, Bariskaner H, Reisli R, Sarkilar G, Cicekci F, Otelcioglu S . Effect of gabapentin on postoperative pain: A randomized, placebo-controlled clinical study. The pain clinic 2005; 17: 95-99 .
  27. Menigaux C, Adam F, Guignard B, Sessler DI, Chauvin M: Preoperative gabapentin decreases anxiety and improves early functional recovery from knee surgery. Anesth Analg 2005 ; 100 : 1394-99 .
  28. Turan A, White PF, Karamanlio lu B, Pamukcu Z: Premedication with gabapentin: the effect on tourniquet pain and quality of intravenous regional anaesthesia. Anesth Analg 2007 ; 104 : 97-101.