Hostname: page-component-586b7cd67f-t7czq Total loading time: 0 Render date: 2024-11-24T10:35:36.774Z Has data issue: false hasContentIssue false
  • English
  • Français

Gabapentin attenuates late but not acute pain after abdominal hysterectomy

Published online by Cambridge University Press:  20 January 2006

A. Fassoulaki ,
E. Stamatakis ,
G. Petropoulos ,
I. Siafaka ,
D. Hassiakos  and
C. Sarantopoulos
A. Fassoulaki
Affiliation:
University of Athens, Medical School, Aretaieio Hospital, Department of Anaesthesiology, Athens, Greece
E. Stamatakis
Affiliation:
University of Athens, Medical School, Aretaieio Hospital, Department of Anaesthesiology, Athens, Greece
G. Petropoulos
Affiliation:
University of Athens, Medical School, Aretaieio Hospital, Department of Anaesthesiology, Athens, Greece
I. Siafaka
Affiliation:
University of Athens, Medical School, Aretaieio Hospital, Department of Anaesthesiology, Athens, Greece
D. Hassiakos
Affiliation:
University of Athens, Medical School, Aretaieio Hospital, Department of Obstetrics and Gynaecology, Athens, Greece
C. Sarantopoulos
Affiliation:
Medical College of Wisconsin, Department of Anesthesiology, Wisconsin, USA
Get access

Extract

Summary

Background and objective: Gabapentin has been suggested to decrease acute postoperative pain. We evaluated the effect of gabapentin on pain after abdominal hysterectomy. Methods: Sixty patients scheduled for abdominal hysterectomy were randomized to receive orally gabapentin 400 mg 6 hourly or placebo. Treatment started 18 h preoperatively and continued for 5 postoperative days. Pain (visual analogue score) and consumption of morphine for 48 h and of oral paracetamol/codeine were recorded after 2, 4, 8, 24 and 48 h and on days 3–5 postoperatively. After 1 month, patients were interviewed by phone for pain, and analgesic intake after hospital discharge. Results: Morphine consumption (mean ± SD) was 35 ± 15.7 mg in the control and 28 ± 12.1 mg in the gabapentin group (P = 0.21). Median number (range) of paracetamol 500 mg/codeine 30 mg tablets taken during days 3–5 was 1.0 (0–6) in the control and 2.0 (0–9) in the gabapentin group (P = 0.35). The visual analogue scores at rest and after cough did not differ between the two groups (F = 0.92, df = 1, P = 0.34 and F = 0.56, df = 1, P = 0.46, respectively). One month after surgery, 22/27 (81%) of the control group and 9/25 (36%) of the gabapentin group reported pain in the surgical area (χ2 = 11.15, P = 0.002), while 11/27 (41%) of controls and 7/25 (28%) of gabapentin patients consumed analgesics for pain (χ2 = 0.93, P = 0.39). The intensity of pain was decreased in the gabapentin group (χ2 = 12.6, P = 0.003). Conclusions: Gabapentin has no effect on immediate pain after abdominal hysterectomy but decreases pain 1 month postoperatively.

Keywords

PHARMACOLOGY, gabapentin, morphine, paracetamol, codeineSURGICAL PROCEDURES, abdominal hysterectomyPAIN POSTOPERATIVE
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 23 , Issue 2 , February 2006 , pp. 136 - 141
Copyright
© 2006 European Society of Anaesthesiology

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Dworkin RH, Backonja M, Rowbotham MC et al. Advances in neuropathic pain. Arch Neurol 2003; 60: 1524–1534.Google Scholar
Jung BF, Ahrendt GM, Oaklander AL, Dworkin RH. Neuropathic pain following breast cancer surgery: proposed classification and research update. Pain 2003; 104: 1–13.Google Scholar
Fassoulaki A, Patris K, Sarantopoulos C, Hogan Q. The analgesic effect of gabapentin and mexiletin after breast surgery for cancer. Anesth Analg 2002; 95: 985–991.Google Scholar
Turan A, Karamanlioglu B, Memis D et al. Analgesic effects of gabapentin after spinal surgery. Anesthesiology 2004; 100: 935–938.Google Scholar
Mao J, Chen LL. Gabapentin and pain management. Anesth Analg 2000; 91: 680–687.Google Scholar
Werner MU, Perkins FM, Holte K, Pedersen JL, Kehlet H. Effects of gabapentin in acute inflammatory pain in humans. Reg Anesth Pain Med 2001; 26: 322–328.Google Scholar
Rorarius MGF, Memmander S, Suominen P et al. Gabapentin for the prevention of postoperative pain after vaginal hysterectomy. Pain 2004; 110: 175–180.Google Scholar
Dierking G, Duedahl TH, Rasmussen ML et al. Effects of gabapentin on postoperative morphine consumption and pain after abdominal hysterectomy: a randomized, double-blind trial. Acta Anaesthesiol Scand 2004; 48: 322–327.Google Scholar
Turan A, Karamanlioglu B, Memis D, Usar P, Pamukcu Z, Ture M. The analgesic effects of gabapentin after total abdominal hysterectomy. Anesth Analg 2004; 98: 1370–1373.Google Scholar
Pandey CK, Priye S, Singh S, Singh U, Singh RB, Singh PK. Preemptive use of gabapentin significantly decreases postoperative pain and rescue analgesic requirements in laparoscopic cholecystectomy. Can J Anesth 2004; 51: 358–363.Google Scholar
Gregg AK, Francis S, Sharpe P, Rowbotham DJ. Analgesic effect of gabapentin premedication in laparoscopic cholecystectomy: a randomized double-blinded placebo-controlled trial. Br J Anaesth 2001; 87: 174P.Google Scholar
Stewart BH, Kugler AR, Thomson PR, Bockbrader HN. A saturable transport mechanism in the intestinal absorption of gabapentin is the underlying cause of the lack of proportionality between increasing dose and drug levels in plasma. Pharm Res 1993; 10: 276–281.Google Scholar
Vollmer KO, Anhut H, Thomann P, Wagner F, Jahncken D. Pharmacokinetic model and absolute bioavailability of the new anticonvulsant gabapentin. Advanc Epileptology 1989; 17: 201–211.Google Scholar
Eckhardt K, Ammon S, Hofmann U, Riebe A, Nadja G, Mikus G. Gabapentin enhances the analgesic effect of morphine. Anesth Analg 2000; 91: 185–191.Google Scholar