Effect of oral gabapentin on postoperative epidural analgesia.
BACKGROUND
Gabapentin has been used successfully as a non-opioid analgesic adjuvant for postoperative pain management. We hypothesized that gabapentin might be a useful adjuvant for postoperative analgesia provided with patient-controlled epidural analgesia (PCEA).


METHODS
Forty patients undergoing lower extremity surgery procedures were randomly assigned to receive (i) placebo capsules (control) or (ii) gabapentin (1.2 g day(-1)) before and for 2 days after surgery. Anaesthetic technique was standardized. Postoperative assessments included verbal rating scale scoring for pain and sedation, PCEA usage, quality of recovery assessment, times of GI function recovery, and patient satisfaction scoring for pain management.


RESULTS
Pain scores at 1, 4, 8, 12, and 16 h (P<0.001), PCEA bolus requirements (n) at 24 [21 (3), 14 (2)], 48 [15 (4), 10 (3)] and 72 [8 (5), 2 (3)] (P<0.05) and paracetamol (mg) consumption [700 (523), 350 (400)]; P<0.05), were significantly lower in the gabapentin-treated patients than in the control group. Patient satisfaction with postoperative pain management at 24 h was better in gabapentin-treated patients [85.5 (7.5), 66.5 (15)]; P<0.001). Gabapentin-treated patients had less motor block when compared with control group. Times of return of bowel function, hospitalization, and resumption of dietary intake were similar in the groups. However, the incidence of dizziness was higher in the gabapentin group (35% vs 5%; P<0.05).


CONCLUSIONS
Oral gabapentin (1.2 g day(-1)) as an adjunct to epidural analgesia decreased pain and analgesic consumption. Despite an increased incidence of dizziness it also increased patient satisfaction.
Turan
A
A
Department of Anaesthesiology, Trakya University, Turkey. alparslanturan@yahoo.com
Kaya
G
G
Karamanlioglu
B
B
Pamukçu
Z
Z
Apfel
C C
CC
D000082:Acetaminophen / Q000008:administration & dosage; D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000588:Amines / Q000009:adverse effects; D015360:Analgesia, Epidural / Q000379:methods*; D016058:Analgesia, Patient-Controlled / Q000379:methods; D000700:Analgesics / Q000009:adverse effects; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage; D003509:Cyclohexanecarboxylic Acids / Q000009:adverse effects; D004244:Dizziness / Q000139:chemically induced; D004334:Drug Administration Schedule; D000077206:Gabapentin; D006801:Humans; D007866:Leg / Q000601:surgery; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods; D010149:Postoperative Pain / Q000188:drug therapy / Q000517:prevention & control*; D017060:Patient Satisfaction; D013223:Statistics as Topic; D005680:gamma-Aminobutyric Acid / Q000009:adverse effects
D000588:Amines; D000700:Analgesics; D018712:Analgesics, Non-Narcotic; D003509:Cyclohexanecarboxylic Acids; D000082:Acetaminophen; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin