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2 results

  • A combination of gabapentin and local anaesthetics attenuates acute and late pain after abdominal hysterectomy

  • A. Fassoulaki, A. Melemeni, E. Stamatakis, G. Petropoulos, C. Sarantopoulos
  • Journal:
    European Journal of Anaesthesiology / Volume 24 / Issue 6 / June 2007
    Published online by Cambridge University Press:
    01 June 2007, pp. 521-528
    Print publication:
    June 2007
  • Background and objective

    Gabapentin and local anaesthetics may decrease postoperative pain and analgesic needs. The aim of the study was to investigate the effect of the combination of these drugs on the analgesic needs as well as on acute and late pain after abdominal hysterectomy.

    Methods

    Sixty patients undergoing abdominal hysterectomy were randomly assigned to receive postoperatively oral gabapentin 400 mg 6 hourly for 7 days plus continuous wound infusion of ropivacaine 0.75% for 30 h or placebo capsules identical to those of gabapentin for 7 days and continuous wound infusion of normal saline for 30 h. Morphine consumption (PCA) for 48 h, paracetamol 500 mg plus codeine 30 mg (Lonalgal® tablets) intake on days 3–7, visual analogue pain scores at rest and after cough during the first 7 postoperative days, the need for analgesics at home and the presence and incidence of pain after 1 month were recorded.

    Results

    The treatment group consumed less cumulative morphine over the first 48 h (31 ± 13.2 mg vs. 50 ± 20.5 mg in controls, P < 0.001) and less Lonalgal® tablets on days 3–7 (z = 2.54, P = 0.011). The visual analogue score values at rest and after cough did not differ between the groups during the first 7 postoperative days. One month postoperatively, fewer patients in the treatment group experienced pain due to surgery than in the control group (17/27 vs. 21/24, P = 0.045).

    Conclusion

    Gabapentin and continuous wound infusion with ropivacaine 0.75% decreased analgesic needs and late pain in patients undergoing abdominal hysterectomy.

  • Gabapentin attenuates late but not acute pain after abdominal hysterectomy

  • A. Fassoulaki, E. Stamatakis, G. Petropoulos, I. Siafaka, D. Hassiakos, C. Sarantopoulos
  • Journal:
    European Journal of Anaesthesiology / Volume 23 / Issue 2 / February 2006
    Published online by Cambridge University Press:
    20 January 2006, pp. 136-141
    Print publication:
    February 2006

  • 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.