This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (3) Citing Articles via Google Scholar Google Scholar Articles by Brogly, N. Articles by Lebuffe, G. Search for Related Content PubMed PubMed Citation Articles by Brogly, N. Articles by Lebuffe, G. Related Collections Postanesthetic Care Unit Pain Medicine Clinical Pharmacology Regional Anesthesia Pharmacology

---

ANALGESIA

Gabapentin Attenuates Late but Not Early Postoperative Pain After Thyroidectomy with Superficial Cervical Plexus Block

Nicolas Brogly, MD^*, Jean-Michel Wattier, MD^*, Grégoire Andrieu, MD^*, Daliana Peres, MD^*, Emanuel Robin, MD, PhD^*, Eric Kipnis, MD, PhD^*, Laurent Arnalsteen, MD, Béatrice Thielemans, DPharm, Bruno Carnaille, MD, PhD, François Pattou, MD, PhD, Benoît Vallet, MD, PhD^*, and Gilles Lebuffe, MD, PhD^*

From the *Department of Anesthesiology and Intensive Care-Section of Pain, Department of Pharmacology, Department of Endocrine and General Surgery, Claude Huriez University Hospital, rue Michel Polonovski, 59037 Lille cedex, France.

Address correspondence and reprint requests to Gilles Lebuffe, MD, PhD, Department of Anesthesiology and Intensive Care-Section of Pain, Claude Huriez University Hospital, rue Michel Polonovski, 59037 Lille cedex, France. Address e-mail to g-lebuffe{at}chru-lille.fr.

Abstract

BACKGROUND: Preoperative oral gabapentin has been shown to reduce postoperative pain. However, the effects of gabapentin as an adjunct to regional anesthesia is unclear and its effects on chronic pain remains unknown. In patients undergoing thyroidectomy, we investigated the effects on early and late (at 6 mo) postoperative pain of preoperative oral gabapentin as an adjunct to superficial cervical plexus block (SCPB).

METHOD: Fifty consecutive consenting patients were randomized to receive either 1200 mg of gabapentin (Group G) or placebo (Group P) 2 h preoperatively. Preoperative anxiety was assessed on a numeric scale from 0 to 6. A SCPB was performed after a standardized induction of anesthesia. The primary outcome, analgesic drug consumption, was assessed during the procedure and postoperatively in the postanesthesia care unit and after discharge to the ward. Over the first 24 h, pain levels at rest and during swallowing were measured on a numeric scale from 0 to 10. If the pain level was more than 4/10 at rest, patients received 1 g/6 h of IV paracetamol and/or 50 mg/6 h of IV tramadol as a rescue analgesic treatment in the interval. The day before operation and 6 mo after thyroidectomy, included patients were asked to answer a neuropathic pain diagnostic questionnaire.

RESULTS: Population characteristics, preoperative anxiety, intraoperative drug consumption, procedure duration, and postoperative care unit stay were comparable in both groups. Analgesic consumption during the first 24 postoperative hours was similar in both groups (G: 3 [0–5] doses/24 h; P: 3 [1–5] doses/24 h; P = NS), as well as pain at rest (G: 2,2 [0.2–3.7]; P: 2 [0–6.3]; P = NS), and during swallowing (G: 2.8 [0.4–8.9]; P: 3 [1.4–6.3]; P = NS]). Eight patients had a diagnostic questionnaire score more than 3, 6 mo after operation versus 2 in preoperative period (P = 0.04). Such delayed neuropathic pain complaints were reported in seven patients receiving SCPB alone and only in one patient receiving both SCPB and preoperative adjunctive oral gabapentin. (P = 0.01).

CONCLUSION: Oral preoperative administration of gabapentin did not modify immediate pain management in thyroidectomy patients receiving SCPB, but prevented delayed neuropathic pain at 6 mo.

This article has been cited by other articles:

				H. Sen, A. Sizlan, O. Yanarates, H. Emirkadi, S. Ozkan, G. Dagli, and A. Turan A Comparison of Gabapentin and Ketamine in Acute and Chronic Pain After Hysterectomy Anesth. Analg., November 1, 2009; 109(5): 1645 - 1650. [Abstract] [Full Text] [PDF]

				H. Ture, M. Sayin, G. Karlikaya, C. A. Bingol, B. Aykac, and U. Ture The Analgesic Effect of Gabapentin as a Prophylactic Anticonvulsant Drug on Postcraniotomy Pain: A Prospective Randomized Study Anesth. Analg., November 1, 2009; 109(5): 1625 - 1631. [Abstract] [Full Text] [PDF]