A combination of gabapentin and local anaesthetics attenuates acute and late pain after abdominal hysterectomy.
OBJECTIVE
Gabapentin and local anaesthetics may decrease postoperative pain and analgesic needs. The aim of the study was to investigate the effect of the combination of these drugs on the analgesic needs as well as on acute and late pain after abdominal hysterectomy.


METHODS
Sixty patients undergoing abdominal hysterectomy were randomly assigned to receive postoperatively oral gabapentin 400 mg 6 hourly for 7 days plus continuous wound infusion of ropivacaine 0.75% for 30 h or placebo capsules identical to those of gabapentin for 7 days and continuous wound infusion of normal saline for 30 h. Morphine consumption (PCA) for 48 h, paracetamol 500 mg plus codeine 30 mg (Lonalgal tablets) intake on days 3-7, visual analogue pain scores at rest and after cough during the first 7 postoperative days, the need for analgesics at home and the presence and incidence of pain after 1 month were recorded.


RESULTS
The treatment group consumed less cumulative morphine over the first 48 h (31 +/- 13.2 mg vs. 50 +/- 20.5 mg in controls, P < 0.001) and less Lonalgal tablets on days 3-7 (z = 2.54, P = 0.011). The visual analogue score values at rest and after cough did not differ between the groups during the first 7 postoperative days. One month postoperatively, fewer patients in the treatment group experienced pain due to surgery than in the control group (17/27 vs. 21/24, P = 0.045).


CONCLUSIONS
Gabapentin and continuous wound infusion with ropivacaine 0.75% decreased analgesic needs and late pain in patients undergoing abdominal hysterectomy.
Fassoulaki
A
A
Department of Anaesthesiology, University of Athens Medical School, Aretaieio Hospital, 76 Vassilissis Sofias Avenue, 11528 Athens, Greece. afassou1@otenet.gr
Melemeni
A
A
Stamatakis
E
E
Petropoulos
G
G
Sarantopoulos
C
C
D000284:Administration, Oral; D000328:Adult; D000577:Amides / Q000008:administration & dosage*; D000588:Amines / Q000008:administration & dosage*; D000701:Analgesics, Opioid / Q000008:administration & dosage; D019162:Anesthetics, Combined / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000008:administration & dosage*; D003509:Cyclohexanecarboxylic Acids / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D000077206:Gabapentin; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects*; D007279:Injections, Subcutaneous; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage; D010147:Pain Measurement / Q000706:statistics & numerical data; D010149:Postoperative Pain / Q000188:drug therapy*; D011446:Prospective Studies; D000077212:Ropivacaine; D018709:Statistics, Nonparametric; D005680:gamma-Aminobutyric Acid / Q000008:administration & dosage*
D000577:Amides; D000588:Amines; D000701:Analgesics, Opioid; D019162:Anesthetics, Combined; D000779:Anesthetics, Local; D003509:Cyclohexanecarboxylic Acids; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin; D009020:Morphine; D000077212:Ropivacaine