The analgesic effects of gabapentin in monitored anesthesia care for ear-nose-throat surgery.
We investigated the efficacy and safety of gabapentin in rhinoplasty or endoscopic sinus surgery patients. Patients received either oral placebo or gabapentin 1200 mg 1 h before surgery. After standard premedication, 25 patients in each group received propofol, fentanyl, and local anesthesia at the operative site. Sedation was maintained by a continuous infusion of propofol adjusted according to the Ramsay scale. Sedation and pain scores were obtained at 5, 15, 30, 45, and 60 min during surgery and 30 min and 2, 4, 6, 8, 12, 16, 20, and 24 h after the procedure. Diclofenac 75 mg IM was administered as a rescue analgesic. Postoperative pain scores and intraoperative pain scores at 45 and 60 min were significantly lower in the gabapentin group. Fentanyl (122 +/- 40 microg versus 148 +/- 42 microg; P < 0.05) and diclofenac (33 +/- 53 mg versus 111 +/- 92 mg; P < 0.001) consumption was smaller and the time to first analgesic request (18 +/- 9 h versus 9 +/- 7 h; P < 0.001) was longer in the gabapentin group. A more frequent incidence of dizziness was found in the gabapentin (versus placebo) group (24% versus 4%, respectively). We conclude that gabapentin provided a significant analgesic benefit for intraoperative and postoperative pain relief in patients undergoing ambulatory rhinoplasty or endoscopic sinus surgery; however, dizziness may be a handicap for ambulatory use.
Department of Anesthesiology and Reanimation, Trakya University Medical Faculty, 22030 Edirne, Turkey. alparslanturan@yahoo.com
Alparslan
A
Turan
Dilek
D
Memiş
Beyhan
B
Karamanlioğlu
Recep
R
Yağiz
Zafer
Z
Pamukçu
Ebru
E
Yavuz
D000085:Acetates / Q000009:adverse effects / Q000627:therapeutic use*; D000328:Adult; D000588:Amines; D000700:Analgesics / Q000009:adverse effects / Q000627:therapeutic use*; D000758:Anesthesia; D000771:Anesthesia, Intravenous; D018686:Anesthetics, Intravenous; D003509:Cyclohexanecarboxylic Acids; D004311:Double-Blind Method; D005260:Female; D005283:Fentanyl; D000077206:Gabapentin; D006801:Humans; D008297:Male; D016343:Monitoring, Intraoperative; D013517:Otorhinolaryngologic Surgical Procedures; D010147:Pain Measurement / Q000187:drug effects; D010149:Postoperative Pain / Q000188:drug therapy*; D010256:Paranasal Sinuses / Q000601:surgery; D015742:Propofol; D012225:Rhinoplasty; D005680:gamma-Aminobutyric Acid
D000085:Acetates; D000588:Amines; D000700:Analgesics; D018686:Anesthetics, Intravenous; D003509:Cyclohexanecarboxylic Acids; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin; D005283:Fentanyl; D015742:Propofol