title: Gabapentin provides effective postoperative analgesia whether administered pre-emptively or post-incision.
abstract: 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.
authors.affiliation: Department of Anaesthesiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences Lucknow 226014, India. ckpandey@sgpgi.ac.in
authors.forename: Chandra Kant
authors.initials: CK
authors.lastname: Pandey
authors.forename: Vinay
authors.initials: V
authors.lastname: Singhal
authors.forename: Mukesh
authors.initials: M
authors.lastname: Kumar
authors.forename: Archana
authors.initials: A
authors.lastname: Lakra
authors.forename: Rajeev
authors.initials: R
authors.lastname: Ranjan
authors.forename: Rashmi
authors.initials: R
authors.lastname: Pal
authors.forename: Mehdi
authors.initials: M
authors.lastname: Raza
authors.forename: Uttam
authors.initials: U
authors.lastname: Singh
authors.forename: Prabhat Kumar
authors.initials: PK
authors.lastname: Singh
mesh_terms: 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*
chemical_list: D000588:Amines; D000700:Analgesics; D000701:Analgesics, Opioid; D003509:Cyclohexanecarboxylic Acids; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin; D005283:Fentanyl