ABSTRACT
This randomized, double-blinded placebo-controlled study was designed to assess the effect of oral clonidine and oral gabapentin on the postoperative patient controlled analgesia by intravenous morphine concerning dose, duration of analgesia, hemodynamic changes and side effects. Sixty female patients were undergoing elective conservative breast surgery under general anaethesia. The patients were randomized to three groups: Clonidine group received oral 5ug/kg, Gabapentin group received oral 300 mg and control group received placebo tab. The medications were given 90 min before surgery. The following parameter were measured:, heart rate, mean arterial pressure, oxygen saturation, pain intensity, the total dose of morphine consumption, nausea and vomiting was recorded. In the clonidine group, there was significant reduction of morphine consumption versus gabapentin and control groups [15.9 +/- 4.6], [25.3 +/- 2.2] and [32.2 +/- 3.5] respectively [P<0.005]. The VAS pain score was significantly lower in clonidine group in comparison to gabapentin and control group throughout the all periods of the study [P<0.005]. There was decrease in HR and MABP in the three studied groups all over the period of the study and this reduction is not significant but in between the three studied groups and between clonidine and gabapentin and between clonidine and control groups there was significant difference in mean arterial blood pressure at 6 hours only [P<0.005]. As regard to the incidence of nausea and vomiting there was insignificant difference in between the three studied groups but there was significant difference between the control group and other two groups. Preemptive oral clonidine was better than oral gabapentin as regard to postoperative morphine consumption, the quality of analgesia and hemodynamic effects. On the other hand, oral gabapentin drug was less of value in management of acute pain