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PAIN MEDICINE

The Analgesic Effects of Gabapentin After Total Abdominal Hysterectomy

Alparslan Turan, MD^*, Beyhan Karamanlolu, MD^*, Dilek Memi, MD^*, Pinar Usar, MD^*, Zafer Pamukçu, MD^*, and Mevlüt Türe, MD PhD

*Department of Anaesthesiology, and the Department of Biostatistics, Trakya University Medical Faculty, Edirne, Turkey

Address correspondence to Alparslan Turan, MD, Trakya University Medical Faculty, Department of Anesthesiology and Reanimation, 22030 Edirne, Turkey. Address email to alparslanturan{at}yahoo.com

We investigated, in a randomized, placebo-controlled, double-blind study, the efficacy and safety of gabapentin on pain after abdominal hysterectomy and on tramadol consumption in patients. The 50 patients were randomized to receive either oral placebo or gabapentin 1200 mg 1 h before surgery. Anesthesia was induced with propofol and maintained with sevoflurane in 50% N₂O/O₂ with a fresh gas flow of 2 L/min (50% N₂O in O₂) and fentanyl (2 µg/kg). All patients received patient-controlled analgesia with tramadol with a 50 mg initial loading dose, 20 mg incremental dose, 10-min lockout interval, and 4-h limit of 300 mg. The incremental dose was increased to 30 mg if analgesia was inadequate after 1 h. Patients were studied at 4, 8, 12, 16, 20, and 24 h for visual analog (VAS) pain scores, heart rate, peripheral oxygen saturation, mean arterial blood pressure, respiratory rate, sedation, and tramadol consumption. The VAS scores in the sitting and supine position at 1, 4, 8, 12, 16, and 20 h were significantly lower in the gabapentin group when compared with the placebo group up to 20 h after surgery. The tramadol consumption at 12, 16, 20, and 24 h and total tramadol consumption were significantly less in the gabapentin group when compared with placebo group. Sedation scores were similar at all the measured times. There were no differences between groups in adverse effects. Preoperative oral gabapentin decreased pain scores and postoperative tramadol consumption in patients after abdominal hysterectomy.

IMPLICATIONS: This randomized, controlled trial examined the effects of preoperative oral gabapentin 1200 mg on postoperative pain and tramadol consumptions. We conclude that preoperative oral gabapentin is effective in reducing postoperative pain scores and tramadol consumption in patients after abdominal hysterectomy.

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