A Comparison of Gabapentin and Ketamine in Acute and Chronic Pain After Hysterectomy

Şen, Hüseyin; Sızlan, Ali; Yanarateş, Ömer; Emirkadı, Hakan; Özkan, Sezai; Dağlı, Güner; Turan, Alparslan

doi:10.1213/ane.0b013e3181b65ea0

Cited by 127 publications

(116 citation statements)

References 25 publications

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“…In the first study, postoperative pain scores were significantly lower in patients treated with gabapentin as compared to patients who received ketamine or placebo. In this trial, a 0.3 mg/kg intravenous (IV) bolus and 0.05 mg/ kg per hour infusion of ketamine was not found to be significantly different to placebo [25]. In a study of 120 patients, Dullenkopf [55] did not find a difference in pain scores at 3 months between patients treated with placebo and either 0.15 mg/kg ketamine IV or 0.5 mg/kg ketamine IV given pre-incision.…”

Section: Ketaminementioning

confidence: 64%

“…However, at the 6-month time-point, it is important to recognize that only two studies were included in the analysis [23,24]. In two studies that were excluded from Sen et al [25,26], postoperative pain scores were significantly lower in the gabapentin group compared with both the ketamine and control groups at 3-and 6-month follow-up following hysterectomy and inguinal herniorrhaphy, respectively. In the remaining excluded gabapentin trial, no significant difference was found between gabapentin and placebo for pain characteristics at 6 months [27].…”

Section: Gabapentinmentioning

confidence: 99%

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Preventive Analgesia and Novel Strategies for the Prevention of Chronic Post-Surgical Pain

Clarke

Poon

Weinrib

et al. 2015

Drugs

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Chronic post-surgical pain (CPSP) is a serious complication of major surgery that can impair a patient's quality of life. The development of CPSP is a complex process which involves biologic, psychosocial, and environmental mechanisms that have yet to be fully understood. Currently perioperative pharmacologic interventions aim to suppress and prevent sensitization with the aim of reducing pain and analgesic requirement in acute as well as long-term pain . Despite the detrimental effects of CPSP on patients, the body of literature focused on treatment strategies to reduce CPSP remains limited and continues to be understudied. This article reviews the main pharmacologic candidates for the treatment of CPSP, discusses the future of preventive analgesia, and considers novel strategies to help treat acute postoperative pain and lessen the risk that it becomes chronic. In addition, this article highlights important areas of focus for clinical practice including: multimodal management of CPSP patients, psychological modifiers of the pain experience, and the development of a Transitional Pain Service specifically designed to manage patients at high risk of developing chronic post-surgical pain. Key PointsThe development of chronic post-surgical pain (CPSP) is a complex process which involves biologic, psychosocial, and environmental mechanisms.Ketamine (an NMDA antagonist) appears to be the pharmacologic agent with the most consistent positive preventive analgesic results.The variation in patient response to pharmacologic agents can be explained, in part, by genetic polymorphisms.Understanding the heritability of CPSP will be useful when developing predictive algorithms to determine the preoperative risk for developing CPSP.Psychological treatments delivered before and after surgery have the potential to influence the trajectory of CPSP from the earliest days, in combination with multimodal, preventive analgesia.

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Section: Ketaminementioning

confidence: 64%

Section: Gabapentinmentioning

confidence: 99%

Preventive Analgesia and Novel Strategies for the Prevention of Chronic Post-Surgical Pain

Clarke

Poon

Weinrib

et al. 2015

Drugs

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“…5 Previous studies have shown that there is a reduced risk of POCP after other types of surgery with the use of gabapentin preoperatively. [17][18][19] In the current report, the observed incidence of POCP and CRPS was lower for the gabapentin group, but it did not reach statistical significance, despite a numerical difference.…”

Section: Resultsmentioning

confidence: 68%

Effect of preoperative gabapentin on pain intensity and development of chronic pain after carpal tunnel syndrome surgical treatment in women: randomized, double-blind, placebo-controlled study

et al. 2016

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Effect of preoperative gabapentin on pain intensity and development of chronic pain after carpal tunnel syndrome surgical treatment in women: randomized, double-blind, placebo-controlled study Efeito da gabapentina pré-operatória na intensidade da dor e desenvolvimento de dor crônica após o tratamento cirúrgico da síndrome do túnel do carpo em mulheres: estudo randomizado duplo-cego controlado com placebo METHODS: Forty patients aged 18 years or over were randomized into two groups: Gabapentin Group received 600 mg of gabapentin preoperatively, one hour prior to surgery, and Control Group received placebo. All the patients received intravenous regional anesthesia comprising 1% lidocaine. Midazolam was used for sedation if needed. Paracetamol was administered for postoperative analgesia as needed. Codeine was used additionally if the paracetamol was insufficient. The following were evaluated: postoperative pain intensity (over a six-month period), incidence of postoperative neuropathic pain (over a sixmonth period), need for intraoperative sedation, and use of postoperative paracetamol and codeine. The presence of neuropathic pain was established using the DN4 (Douleur Neuropathique 4) questionnaire. Complex regional pain syndrome was diagnosed using the Budapest questionnaire. RESULTS: No differences in the need for sedation, control over postoperative pain or incidence of chronic pain syndromes (neuropathic or complex regional pain syndrome) were observed. No differences in postoperative paracetamol and codeine consumption were observed. CONCLUSIONS: Preoperative gabapentin (600 mg) did not improve postoperative pain control, and did not reduce the incidence of chronic pain among patients undergoing carpal tunnel syndrome surgery. RESUMO CONTEXTO E OBJETIVOS:Analgesia pós-operatória eficaz é importante para reduzir a incidência de dor crônica. Este estudo avaliou o efeito da gabapentina pré-operatória na analgesia pós-operatória e na incidência de dor crônica em pacientes submetidos à cirurgia para tratamento da síndrome do túnel do carpo. DESENHO E LOCAL: Randomizado, duplo cego, Universidade Federal de São Paulo. MÉTODOS: Os 40 pacientes com 18 anos ou mais de idade foram distribuídos aleatoriamente em dois grupos: o Grupo Gabapentina recebeu 600 mg de gabapentina no pré-operatório uma hora antes da cirurgia, e o Grupo Controle recebeu placebo. Todos os pacientes receberam anestesia regional intravenosa com lidocaína a 1%. Midazolam foi utilizado para sedação, se necessário. Paracetamol foi administrado para analgesia pós-operatória, conforme necessário, e codeína, se o paracetamol fosse insuficiente. Foram avaliados: a intensidade da dor pós-operatória (durante seis meses), a incidência de dor neuropática pós-operatória (durante seis meses), a necessidade de sedação intra-operatória e o uso de paracetamol e codeína no pós-operatório. A presença de dor neuropática foi estabelecida utilizando-se o questionário DN4 (dor neuropática 4). Síndrome de dor regional complexa foi diagnosticada através do questionário ...

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“…The analgesic effect of gabapentin was detected in the study of Sen et al [38] in patients undergoing abdominal hysterectomy, which compared the effect of gabapentin 1200 mg to ketamine group which ingested oral placebo capsules, then IV bolus of ketamine 0.3 mg/kg before incision then 0.05 mg/kg/hour IV infusion of ketamine until the end of operation; they detected that group received gabapentin had significantly lower pain scores compared to ketamine and control groups with significant decreased opioid requirement in gabapentin and ketamine groups compared to control group (P < 0.001).…”

Section: Discussionmentioning

confidence: 94%

A Comparative Study of Effect of Intravenous Lidocaine Infusion, Gabapentin and Their Combination on Postoperative Analgesia after Thyroid Surgery

Shal¹

2017

OJAnes

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A Comparison of Gabapentin and Ketamine in Acute and Chronic Pain After Hysterectomy

Abstract: Gabapentin and ketamine are similar in improving early pain control and in decreasing opioid consumption; however, gabapentin also prevented chronic pain in the first 6 postoperative months.

Cited by 127 publications

References 25 publications

Preventive Analgesia and Novel Strategies for the Prevention of Chronic Post-Surgical Pain

Preventive Analgesia and Novel Strategies for the Prevention of Chronic Post-Surgical Pain

Effect of preoperative gabapentin on pain intensity and development of chronic pain after carpal tunnel syndrome surgical treatment in women: randomized, double-blind, placebo-controlled study

A Comparative Study of Effect of Intravenous Lidocaine Infusion, Gabapentin and Their Combination on Postoperative Analgesia after Thyroid Surgery

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