Gabapentin provides effective postoperative analgesia whether administered pre-emptively or post-incision.
OBJECTIVE
We investigated the effects of pre-incision and post-incision administration of gabapentin on postoperative pain and fentanyl consumption associated with open donor nephrectomy.


METHODS
Sixty ASA I subjects were randomly allocated into three groups to receive gabapentin 600 mg two hours before surgery and placebo after surgical incision (pre-incision group), placebo two hours before surgery and gabapentin 600 mg after surgical incision (post-incision group), or placebo two hours before surgery and after surgical incision (placebo group). After surgery, pain was assessed using a visual analogue scale (VAS), (1-10 cm) at time points 0, 6, 12, 18, and 24 hr. Subjects received patient-controlled-analgesia (fentanyl 1.0 microg x kg(-1) subject activated dose). Total fentanyl consumption in each group was recorded.


RESULTS
Subjects of pre-incision and post-incision groups had lower VAS scores at all time points (3.1 +/- 1.8, 2.9 +/- 1.3, 2.8 +/- 1.3, 2.5 +/- 0.9, 2.5 +/- 1.5 and 3.6 +/- 1.1, 3.0 +/- 1.2, 3.2 +/- 1.1, 2.9 +/- 1.0, 2.6 +/- 2.2) compared to placebo group (6.6 +/- 1.3, 5.0 +/- 1.0, 4.4 +/- 0.7, 4.2 +/- 0.8, 3.9 +/- 1.0). They also used less fentanyl (563.3 microg +/- 252.8 and 624.0 microg +/- 210.5 respectively) compared to placebo (924.7 microg +/- 417.5), (P < 0.05). No difference in total fentanyl consumption and pain scores at any time points were observed between pre- and post-incision groups.


CONCLUSIONS
Pre-incision administration of 600 mg gabapentin has no added benefit over post-incision administration in terms of pain scores and fentanyl consumption in subjects undergoing open donor nephrectomy.
Pandey
Chandra Kant
CK
Department of Anaesthesiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences Lucknow 226014, India. ckpandey@sgpgi.ac.in
Singhal
Vinay
V
Kumar
Mukesh
M
Lakra
Archana
A
Ranjan
Rajeev
R
Pal
Rashmi
R
Raza
Mehdi
M
Singh
Uttam
U
Singh
Prabhat Kumar
PK
D000284:Administration, Oral; D000328:Adult; D000588:Amines / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016058:Analgesia, Patient-Controlled; D000700:Analgesics / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use; D003509:Cyclohexanecarboxylic Acids / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage / Q000627:therapeutic use; D000077206:Gabapentin; D006801:Humans; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D011446:Prospective Studies; D005680:gamma-Aminobutyric Acid / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*
D000588:Amines; D000700:Analgesics; D000701:Analgesics, Opioid; D003509:Cyclohexanecarboxylic Acids; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin; D005283:Fentanyl