Preemptive use of gabapentin significantly decreases postoperative pain and rescue analgesic requirements in laparoscopic cholecystectomy

  • Chandra Kant Pandey
  • Shio Priye
  • Surendra Singh
  • Uttam Singh
  • Ram Badan Singh
  • Prabhat Kumar Singh
Regional Anesthesia and Pain

Abstract

Purpose

To evaluate the comparative preemptive effects of gabapentin and tramadol on postoperative pain and fentanyl requirement in laparoscopic cholecystectomy.

Methods

Four hundred fifty-nine ASA I and II patients were randomly assigned to receive 300 mg gabapentin, 100 mg tramadol or placebo in a double-blind manner two hours before laparoscopic cholecystectomy under general anesthesia. Postoperatively, patients’ pain scores were recorded on a visual analogue scale every two hours for the initial 12 hr and thereafter every three hours for the next 12 hr. Patients received fentanyl 2μg·kg−1 intravenously on demand. The total fentanyl consumption for each patient was recorded.

Results

Patients in the gabapentin group had significantly lower pain scores at all time intervals (2.65 ± 3.00, 1.99 ± 1.48, 1.40 ± 0.95, 0.65 ± 0.61) in comparison to tramadol (2.97 ± 2.35, 2.37 ± 1.45, 1.89 ± 1.16, 0.87 ± 0.50) and placebo (5.53 ± 2.22, 3.33 ± 1.37, 2.41 ± 1.19, 1.19 ± 0.56). Significantly less fentanyl was consumed in the gabapentin group (221.16 ± 52.39 μg) than in the tramadol (269.60 ± 44.17 μg) and placebo groups (355.86 ± 42.04 μg;P < 0.05). Sedation (33.98%), nausea/retching/vomiting (24.8%) were the commonest side effects in the gabapentin group whereas respiratory depression (3.9%) was the commonest in the tramadol group and vertigo (7.8%) in the placebo group.

Conclusion

Preemptive use of gabapentin significantly decreases postoperative pain and rescue analgesic requirement in laparoscopic cholecystectomy.

L’usage préventif de gabapentine diminue significativement la douleur postopératoire et les besoins d’analgésique de secours lors d’une cholécystectomie laparoscopique

Résumé

Objectif

Évaluer et comparer les effets préventifs de la gabapentine et du tramadol sur la douleur postopératoire et les besoins de fentanyl lors d’une cholécystectomie laparoscopique.

Méthode

Quatre cent cinquante-neuf patients d’état physique ASA I et II ont été répartis au hasard et ont reçu 300 mg de gabapentine, 100 mg de tramadol ou un placebo, en double aveugle, deux heures avant la cholécystectomie laparoscopique sous anesthésie générale. Après l’opération, les scores de douleur ont été notés sur l’échelle visuelle analogique toutes les deux heures pendant les 12 premières heures et toutes les trois heures pendant les 12 h suivantes. Les patients ont reçu 2 μg·kg−1 de fentanyl intraveineux sur demande et la consommation totale a été notée pour chacun.

Résultats

Les patients du groupe gabapentine ont présenté des scores de douleur significativement plus bas pour tous les intervalles de mesures (2,65 ± 3,00; 1,99 ± 1,48; 1,40 ± 0,95; 0,65 ± 0,61) que ceux du groupe tramadol (2,97 ± 2,35; 2,37 ± 1,45; 1,89 ± 1,16; 0,87 ± 0,50) ou placebo (5,53 ± 2,22; 3,33 ± 1,37; 2,41 ± 1,19; 1,19 ± 0,56). La demande de fentanyl a été significativement plus basse avec la gabapentine (221,16 ± 52,39 μg) qu’avec le tramadol (269,60 ± 44,17 μg) ou le placebo (355,86 ± 42,04 μg; P < 0,05). La sédation (33,98 %), les nausées/haut-lec∁ur/vomissements (24,8 %) ont été les effets négatifs les plus fréquents avec la gabapentine tandis que la dépression respiratoire (3,9 %) a été plus fréquente avec le tramadol et le vertige (7,8 %) avec le placebo.

Conclusion

L’usage préventif de gabapentine diminue significativement la douleur postopératoire et la demande d’analgésique de secours lors de la cholécystectomie laparoscopique.

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Copyright information

© Canadian Anesthesiologists 2004

Authors and Affiliations

  • Chandra Kant Pandey
    • 1
  • Shio Priye
    • 1
  • Surendra Singh
    • 1
  • Uttam Singh
    • 1
  • Ram Badan Singh
    • 1
  • Prabhat Kumar Singh
    • 1
  1. 1.Department of AnaesthesiologySanjay Gandhi Postgraduate Institute of Medical SciencesLucknowIndia

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