Effects of preoperative gabapentin on postoperative nausea and vomiting after open cholecystectomy: a prospective randomized double-blind placebo-controlled study

ABSTRACT

To evaluate the effect of gabapentin on the incidence and severity of postoperative nausea and vomiting [PONV] after open cholecystectomy. A total of 90 patients scheduled for elective open cholecystectomy were randomly assigned to either a gabapentin group [600 mg, 2 h before surgery] or a placebo group. For the analysis, 1 patient was excluded from the gabapentin group and 2 patients from the placebo group. A standard technique was used for anesthesia. Pethidine and metoclopramide were used for postoperative management of pain and nausea/vomiting, respectively. The prevalence of PONV, its severity [measured on visual analogue scale, VAS], and total pethidine and metoclopramide use in the first 24 h after the operation were recorded. There were no demographic differences between the two groups. Of the 44 patients given gabapentin, 16 [36.6%] and 28 of 43 [65.2%] placebo patients developed PONV; the difference was statistically significant [p = 0.02]. However, there was no difference in the severity of PONV between the gabapentin and placebo groups [p = 0.12]. Gabapentin patients used less pethidine [28.33 +/- 129 mg] and metoclopramide [6.0 +/- 6.3 mg] than the placebo group [35.1 +/- 15.1 and 9.33 +/- 7.1 mg, respectively]. The differences were statistically significant [pethidine p = 0.002, metoclopramide p = 0.033]. However, gabapentin did not reduce postoperative pain significantly [p = 0.096]. Our data show that gabapentin not only reduced PONV after open cholecystectomy, but also reduced the need for additional postoperative analgesics