Preemptive use of gabapentin significantly decreases postoperative pain and rescue analgesic requirements in laparoscopic cholecystectomy.
OBJECTIVE
To evaluate the comparative preemptive effects of gabapentin and tramadol on postoperative pain and fentanyl requirement in laparoscopic cholecystectomy.


METHODS
Four hundred fifty-nine ASA I and II patients were randomly assigned to receive 300 mg gabapentin, 100 mg tramadol or placebo in a double-blind manner two hours before laparoscopic cholecystectomy under general anesthesia. Postoperatively, patients' pain scores were recorded on a visual analogue scale every two hours for the initial 12 hr and thereafter every three hours for the next 12 hr. Patients received fentanyl 2 micro g*kg(-1) intravenously on demand. The total fentanyl consumption for each patient was recorded.


RESULTS
Patients in the gabapentin group had significantly lower pain scores at all time intervals (2.65 +/- 3.00, 1.99 +/- 1.48, 1.40 +/- 0.95, 0.65 +/- 0.61) in comparison to tramadol (2.97 +/- 2.35, 2.37 +/- 1.45, 1.89 +/- 1.16, 0.87 +/- 0.50) and placebo (5.53 +/- 2.22, 3.33 +/- 1.37, 2.41 +/- 1.19, 1.19 +/- 0.56). Significantly less fentanyl was consumed in the gabapentin group (221.16 +/- 52.39 micro g) than in the tramadol (269.60 +/- 44.17 micro g) and placebo groups (355.86 +/- 42.04 micro g; P < 0.05). Sedation (33.98%), nausea/retching/vomiting (24.8%) were the commonest side effects in the gabapentin group whereas respiratory depression (3.9%) was the commonest in the tramadol group and vertigo (7.8%) in the placebo group.


CONCLUSIONS
Preemptive use of gabapentin significantly decreases postoperative pain and rescue analgesic requirement in laparoscopic cholecystectomy.
Pandey
Chandra Kant
CK
Department of Anaesthesiology and Biostatistics, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India. ckpandy@sgpgi.ac.in
Priye
Shio
S
Singh
Surendra
S
Singh
Uttam
U
Singh
Ram Badan
RB
Singh
Prabhat Kumar
PK
D000085:Acetates / Q000009:adverse effects / Q000627:therapeutic use*; D000328:Adult; D000588:Amines; D000698:Analgesia / Q000379:methods; D000700:Analgesics / Q000009:adverse effects / Q000627:therapeutic use; D000701:Analgesics, Opioid / Q000009:adverse effects / Q000627:therapeutic use; D000704:Analysis of Variance; D018686:Anesthetics, Intravenous / Q000627:therapeutic use; D002763:Cholecystectomy; D003509:Cyclohexanecarboxylic Acids; D004311:Double-Blind Method; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage / Q000627:therapeutic use*; D000077206:Gabapentin; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D013997:Time Factors; D014147:Tramadol / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome; D005680:gamma-Aminobutyric Acid
D000085:Acetates; D000588:Amines; D000700:Analgesics; D000701:Analgesics, Opioid; D018686:Anesthetics, Intravenous; D003509:Cyclohexanecarboxylic Acids; D014147:Tramadol; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin; D005283:Fentanyl