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Category: Volume 07 Issue 01 January 2019
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Title: Effect of Pre-Emptive Gabapentin for Post-Operative Analgesia in Vaginal Hysterectomy under Spinal Anaesthesia

Authors: Pradipta Kumar Patel, Sumati Kandi, Aparna Sahu, Sapan Kumar Jena, Siddhanta Choudhury, Saurabh Agrawal

 DOI: https://dx.doi.org/10.18535/jmscr/v7i1.161

Abstract

Background and Aims: Various drugs and methods have been tried to alleviate postoperative pain, perioperative anxiety, and apprehension. Opioids, Non-steroidal anti-inflammatory drugs, Cyclooxygenase inhibitors, and many local anesthetic techniques have been used, but every approach has their own side effects and limitations. Recent works have shown that gabapentin may have an opioid-sparing effect and anxiolytic property, without any respiratory depression, gastrointestinal, hematological, renal and hepatic adverse effects.

We conducted this study to assess the efficacy of a single dose oral gabapentin as pre-emptive analgesia in comparison to placebo for postoperative pain control in adult subjects undergoing vaginal hysterectomy under spinal anesthesia.

Material & Methods: This randomised double-blind study was conducted in 100 ASA grade I and II patients of age 40-60 years posted for abdominal hysterectomy. Patients were divided into two groups of 50 each. Group G received 600mg oral gabapentin 1 hour before vaginal hysterectomy and Group C received placebo. Total abdominal hysterectomy was carried out under spinal anesthesia. Pulse rate, SBP, DBP, and SpO2 over a 24-hour period, Total tramadol consumption, sedation scores, incidence of nausea and vomiting and other adverse effects were noted. Data was analysed with SPSS version 23 using appropriate statistical tests.

Results: There were significantly lower pain scores and reduced analgesic requirements in gabapentin group over a 24-hour period. There was better hemodynamic stability in the gabapentin group. Incidence of nausea, vomiting, and adverse events was higher in patients of gabapentin group, although not significant statistically.

Conclusion: Gabapentin used a pre-emptive analgesic, reduces post-operative analgesic requirements.

Keywords: Gabapentin, Post-operative analgesia, Pre-emptive analgesia, Abdominal Hysterectomy.

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Corresponding Author

Pradipta Kumar Patel

Associate Professor, Department of Anesthesiology, VIMSAR