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AMBULATORY ANESTHESIA

The Analgesic Effects of Gabapentin in Monitored Anesthesia Care for Ear-Nose-Throat Surgery

Alparslan Turan, MD^*, Dilek Memi, MD^*, Beyhan Karamanlolu, MD^*, Recep Yaz, MD, Zafer Pamukçu, MD^*, and Ebru Yavuz

Departments of *Anaesthesiology, Ear-Nose-Throat Surgery, and Biostatistics, Trakya University Medical Faculty, Edirne, Turkey

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

We investigated the efficacy and safety of gabapentin in rhinoplasty or endoscopic sinus surgery patients. Patients received either oral placebo or gabapentin 1200 mg 1 h before surgery. After standard premedication, 25 patients in each group received propofol, fentanyl, and local anesthesia at the operative site. Sedation was maintained by a continuous infusion of propofol adjusted according to the Ramsay scale. Sedation and pain scores were obtained at 5, 15, 30, 45, and 60 min during surgery and 30 min and 2, 4, 6, 8, 12, 16, 20, and 24 h after the procedure. Diclofenac 75 mg IM was administered as a rescue analgesic. Postoperative pain scores and intraoperative pain scores at 45 and 60 min were significantly lower in the gabapentin group. Fentanyl (122 ± 40 µg versus 148 ± 42 µg; P < 0.05) and diclofenac (33 ± 53 mg versus 111 ± 92 mg; P < 0.001) consumption was smaller and the time to first analgesic request (18 ± 9 h versus 9 ± 7 h; P < 0.001) was longer in the gabapentin group. A more frequent incidence of dizziness was found in the gabapentin (versus placebo) group (24% versus 4%, respectively). We conclude that gabapentin provided a significant analgesic benefit for intraoperative and postoperative pain relief in patients undergoing ambulatory rhinoplasty or endoscopic sinus surgery; however, dizziness may be a handicap for ambulatory use.

IMPLICATIONS: Gabapentin has been demonstrated to be effective in different pain models. This study demonstrated that gabapentin decreases intraoperative and postoperative pain scores and analgesic requirements in rhinoplasty or endoscopic sinus surgery patients; however, dizziness may be a handicap for use in ambulatory patients.

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