Combined preoperative use of celecoxib and gabapentin in the management of postoperative pain.
BACKGROUND
In 2005 we reported a study on the efficacy of the preoperative use of the selective COX-2 inhibitor celecoxib (Celebrex) for reducing both postoperative pain and opioid requirements in patients undergoing bilateral subpectoral breast augmentation. Our findings showed that patients who received 400 mg of celecoxib 30 min before surgery required significantly less postoperative opioid analgesics compared with those given a placebo. Gabapentin (Neurontin) is an agent commonly used to control neuropathic pain. Here we describe a prospective study assessing the efficacy of preoperative gabapentin in combination with celecoxib for reducing postoperative pain and opioid requirements in elective subpectoral breast augmentation.


METHODS
One hundred eighteen patients were given 1200 mg of gabapentin and 400 mg of celecoxib 30-60 min before surgery. From the day of surgery until postoperative day 5, patients documented any use of analgesics and recorded their degree of pain. Results were then compared with those of our previous study in which only celecoxib was used.


RESULTS
The combination of gabapentin and celecoxib was found to be significantly superior (p < 0.001) in reducing postoperative pain and opioid requirements than celecoxib alone in the management of postoperative pain and opioid requirements.


CONCLUSIONS
To decrease postoperative opioid requirements, we recommend 400 mg of celecoxib and 1200 mg of gabapentin taken 30-60 min before surgery by patients undergoing subpectoral breast augmentation or a comparable plastic surgery procedure.
Parsa
Alan A
AA
Department of Surgery, Division of Plastic Surgery, John A. Burns School of Medicine, University of Hawaii, 1329 Lusitana Street, Suite 807, Honolulu, HI, 96813, USA.
Sprouse-Blum
Adam S
AS
Jackowe
David J
DJ
Lee
Michael
M
Oyama
Jared
J
Parsa
F Don
FD
D000284:Administration, Oral; D000328:Adult; D000588:Amines / Q000008:administration & dosage*; D000701:Analgesics, Opioid / Q000008:administration & dosage; D019928:Breast Implantation / Q000009:adverse effects / Q000379:methods*; D000068579:Celecoxib; D015331:Cohort Studies; D003509:Cyclohexanecarboxylic Acids / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D000077206:Gabapentin; D006801:Humans; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000503:physiopathology / Q000517:prevention & control*; D017060:Patient Satisfaction; D011300:Preoperative Care / Q000379:methods; D011720:Pyrazoles / Q000008:administration & dosage*; D012189:Retrospective Studies; D013449:Sulfonamides / Q000008:administration & dosage*; D016896:Treatment Outcome; D055815:Young Adult; D005680:gamma-Aminobutyric Acid / Q000008:administration & dosage*
D000588:Amines; D000701:Analgesics, Opioid; D003509:Cyclohexanecarboxylic Acids; D011720:Pyrazoles; D013449:Sulfonamides; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin; D000068579:Celecoxib