Effect of gabapentin on opioid requirements in patients undergoing total abdominal hysterectomy

ABSTRACT

Gabapentin possesses antihyperalgesic and antiallodynia properties and has a definite role in neuropathic pain relief. In this study, we tried to determine whether preemptive use of gabapentin can result in reduction of intra and postoperative pain and narcotic [nalbuphine] requirements in patients undergoing total abdominal hysterectomy [TAH]. In this randomized, double-blind controlled trial, 35 patients [study group] undergoing TAH received gabapentin 1200 mg and 35 patients [control group] received placebo orally two hours before induction of anesthesia. Intra-operatively, an increase in blood pressure and heart rate were taken as an indicator of pain during surgery and nalbuphine at 0.05-mg/kg body weight was administered as a rescue analgesia. Postoperatively, for the initial 24 hours, pain was assessed on a Visual Analogue Scale [VAS score 1-10, score 1-3 considered mild pain, 4-7 moderate pain and 8-10 as severe pain]. If score was more than 3 a top up dose of nalbuphine 0.05 mg/kg was administered intravenously. Total nalbuphine consumption during the intraoperative period and initial 24 hours postoperative period was recorded for each patient. Thirty four patients in the gabapentin group [study group] and 35 patients in the Placebo group [control group] completed the study. Overall, pain scores in the gabapentin group were significantly lower as compared to the Placebo group. The total nalbuphine consumption was 13.2 +/- 4.7 mg [mean +/- SD] in the gabapentin group versus 24.3 +/- 9.2 mg in the Placebo group [P < 0.001]. Preemptive use of gabapentin resulted in reduction of intra and postoperative narcotic [Nalbuphine] requirements in patients undergoing total abdominal hysterectomy