Effect of preoperative gabapentin after transurethral prostate resection under general anesthesia

Abstract

Objectives: To investigate whether preoperative oral gabapentin could reduce postoperative pain, analgesic consumption and the occurrence of catheter-related bladder discomfort (CRBD). Methods: In this study, participants randomly received either 600 mg gabapentin or placebo orally 2 h prior to transurethral prostate resection. Visual analogue scale and Ramsay sedation scale was utilized to assess pain intensity and sedation status after surgery. Intravenous 1.5 mg.kg-1 tramadol was used for postoperative analgesia. Pain intensity, sedation status, CRBD, tramadol consumption, side effects and the overall satisfaction degree were assessed and recorded for 48 h after tracheal extubation. Original Article Results: Ninety participants given gabapentin and 91 participants given placebo completed the study. Lower visual analogue scale scores, less tramadol consumption, longer time to the first analgesic requirement, lower incidence of CRBD and nausea and higher satisfaction degree were detected in the patients receiving gabapentin compared with the patients receiving placebo. Conclusion: Preoperative oral gabapentin reduced postoperative visual analogue scale scores, tramadol consumption and the occurrence rate of CRBD and nausea, and consequently, increased the degree of patients' satisfaction after transurethral prostate resection.

Preoperative Oral Gabapentin in the Management of Postoperative Catheter-Related Bladder Discomfort in Adults: A Systematic Review and Meta-Analysis

“…The comparisons were as follows: five comparisons of placebo controls to gabapentin experimental arms ( 13 , 19 ) and one blank control ( 18 ). Two studies investigated the role of gabapentin in percutaneous nephrolithotomy ( 13 , 15 ), one study involved transurethral resection of bladder tumor ( 14 ), participants in one study underwent transurethral resection of the prostate ( 16 ), one study involved abdominal hysterectomy ( 18 ), and participants in one study received flexible ureteroscopes ( 17 ). In all studies, catheterization was done by using a 16-Fr Foley catheter, except one ( 16 ) without specifying the size of catheter and one ( 17 ) using a 16-Fr Foley catheter for man while a 12-Fr Foley catheter for woman.…”

“…Rescue analgesics was performed in four of the included studies ( 13 , 15 , 16 , 18 ), but due to large clinical heterogeneity, pooling of these data and meta-analysis was considered inappropriate. Therefore, a descriptive analysis has been adopted.…”

“…They found that the total consumption of paracetamol and pethidine for 24 h after surgery were significantly lower in the gabapentin group compared with the control group ( p < 0.001). Wang et al ( 16 ) determined that gabapentin was effective for decreasing postoperative tramadol use. Not only the percentage of patients requiring tramadol and dose of tramadol use had a decrease, but also the time to the first tramadol request had prolonged within 48 h following surgery ( p < 0.05).…”

“…A total of 196 studies were identified from an initial search of the databases and other sources. Among them, 6 RCTs with 679 patients satisfied the inclusion criteria and were used for the systematic review (13)(14)(15)(16)(17)(18). The articles were published from 2007 to 2020 and the sample sizes ranged between 40 and 181.…”

“…Furthermore, the incidence of CRBD was significantly reduced at 0, 2, and 6 h after surgery in the gabapentin group (0 h: RR = 0.59, 95% CI: 0.46 to 0.74, p < 0.0001, GRADE = low; 2 h: RR = 0.62, 95% CI: 0.51 to 0.75, p < 0.00001, GRADE = moderate; 6 h: RR = 0.66, 95% CI: 0.52 to 0.83, p < 0.001, GRADE = moderate). Rescue analgesics was performed in four of the included studies (13,15,16,18), but due to large clinical heterogeneity, pooling of these data and meta-analysis was considered inappropriate. Therefore, a descriptive analysis has been adopted.…”