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Does low-dose gapapentin reduce opioid use postoperatively?: A randomized controlled trial in women undergoing reconstructive pelvic surgery

  • Adrienne L. K. Li
  • Kristin Wadsworth
  • Naveed T. Siddiqui
  • May Alarab
  • Colleen D. McDermott
  • Nucelio Lemos
  • Ashraf Dawood
  • Danny Lovatsis
Original Article

Abstract

Introduction and hypothesis

Pre-emptive gabapentin has been shown to decrease postoperative pain in abdominal and vaginal hysterectomy. However, the effect of pre-emptive low-dose gabapentin has not been studied in vaginal hysterectomy combined with concomitant pelvic reconstruction.

Methods

A randomized double-blind placebo-controlled trial assessed all women seen for symptomatic prolapse requiring vaginal hysterectomy with concomitant pelvic reconstruction with or without midurethral sling. Gabapentin dosing was 600 mg (<65 years) or 300 mg (>65 years). The primary outcome was reduction in opioid consumption in the first 24 h after surgery. Secondary outcomes included sedation and prolongation of recovery room stay. Sample-size calculations indicated a need for 22 participants/group. Student’s t test was used to compare differences in oral administration of morphine equivalents in the first 24 h postoperatively, time from end of surgery to leaving the recovery room, and length of recovery room stay. Mann–Whitney U test was used to compare visual analog scale (VAS) scores for anxiety, drowsiness/sedation, pain, and nausea.

Results

Twenty-one patients received gabapentin and 26 a placebo capsule. Groups were similar with respect to age, menopause status, parity, American Society of Anesthesiologist (ASA) class, and concomitant procedures. There were also no significant differences between groups in opioid requirements within the first 24 h after surgery, time from end of surgery to leaving the recovery room, length of time in recovery room, or VAS scores.

Conclusions

Pre-emptive gabapentin at our institutional low doses did not significantly affect postoperative pain and opioid requirements in women undergoing vaginal hysterectomy with concomitant reconstruction.

Trial registration

www.clinicaltrials.gov, #NCT02999724.

Keywords

Postoperative pain Pelvic organ prolapse Stress urinary incontinence Vaginal hysterectomy Opioids Female 

Notes

Acknowledgements

We are grateful to the perioperative nursing staff at Mount Sinai Hospital for their assistance in this study.

Funding

None.

Compliance with ethical standards

Conflict of interest

None.

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Copyright information

© The International Urogynecological Association 2018

Authors and Affiliations

  • Adrienne L. K. Li
    • 1
  • Kristin Wadsworth
    • 1
  • Naveed T. Siddiqui
    • 2
  • May Alarab
    • 1
  • Colleen D. McDermott
    • 1
  • Nucelio Lemos
    • 1
  • Ashraf Dawood
    • 3
  • Danny Lovatsis
    • 1
  1. 1.Department of Obstetrics and GynecologyMount Sinai HospitalTorontoCanada
  2. 2.Department of Anesthesia and Pain ManagementMount Sinai HospitalTorontoCanada
  3. 3.Department of Obstetrics and GynecologyWomen’s Specialized HospitalKing Fahad Medical CitySaudi Arabia

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