Preemptive Analgesic Efficacy of Gabapentin and Nimesulide in the Functional Endoscopic Sinus Surgery

Kilic, Ertugrul; Mızrak, Ayşe; Göksu, Sıtkı; Cesur, Mehmet

doi:10.5505/agri.2014.25582

Cited by 8 publications

(5 citation statements)

References 15 publications

(20 reference statements)

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“…Figure and Table detail the 133 trials we included in the review, with our categorisation of risks of bias in Fig. . We excluded one duplicate trial , three trials that were unavailable as full text , five trials that did not use a placebo , one trial that used combination therapy and two uncontrolled trials .…”

Section: Resultsmentioning

confidence: 99%

A systematic review and meta‐regression analysis of prophylactic gabapentin for postoperative pain

et al. 2015

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SummaryWe searched MEDLINE, Embase, CINAHL, AMED and CENTRAL databases until December 2014 and included 133 randomised controlled trials of peri-operative gabapentin vs placebo. Gabapentin reduced mean (95% CI) 24-h morphine-equivalent consumption by 8.44 (7.26-9.62) mg, p < 0.001, whereas more specific reductions in morphine equivalents were predicted (R 2 = 90%, p < 0.001) by the meta-regression equation: 3.73 + (À0.378 9 control morphine consumption (mg)) + (À0.0023 9 gabapentin dose (mg)) + (À1.917 9 anaesthetic type), where 'anaesthetic type' is '1' for general anaesthesia and '0' for spinal anaesthesia. The type of surgery was not independently associated with gabapentin effect. Gabapentin reduced postoperative pain scores on a 10-point scale at 1 h, 2 h, 6 h, 12 h and 24 h by a mean (95% CI) of: 1.68 (1.35-2.01); 1.21 (0.88-1.55); 1.28 (0.98-1.57); 1.12 (0.91-1.33); and 0.71 (0.56-0.87), respectively, p < 0.001 for all. The risk ratios (95% CI) for postoperative nausea, vomiting, pruritus and sedation with gabapentin were: 0.78 (0.69-0.87), 0.67 (0.59-0.76), 0.64 (0.51-0.80) and 1.18 (1.09-1.28), respectively, p < 0.001 for all. Gabapentin reduced pre-operative anxiety and increased patient satisfaction on a 10-point scale by a mean (95% CI) of 1.52 (0.78-2.26) points and 0.89 (0.22-1.57) points, p < 0.001 and p = 0.01, respectively. All the effects of gabapentin may have been overestimated by statistically significant small study effects.

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Section: Resultsmentioning

confidence: 99%

A systematic review and meta‐regression analysis of prophylactic gabapentin for postoperative pain

et al. 2015

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“…[8][9][10][11][12] For sinonasal procedures such as endoscopic sinus surgery (ESS) and septoplasty, prior RCTs have found that gabapentin administered preoperatively resulted in reduced pain levels and opioid consumption intraoperatively or immediately after surgery. [13][14][15][16][17] Most recently, a retrospective cohort study with 57 patients investigated the impact of preoperative gabapentin on postoperative pain control for 1 week after ESS and/or septoplasty. However, they did not find any analgesic or opioid cessation benefits to persist after the 7-day followup period.…”

Section: Introductionmentioning

confidence: 99%

Postoperative Gabapentin's Effect on Opioid Consumption and Pain Control Following Sinonasal Surgery

Yang

Suh

et al. 2022

The Laryngoscope

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Objective This study investigates the impact of postoperative gabapentin on opioid consumption and pain control following endoscopic sinus surgery (ESS) and/or septoplasty. Methods Patients who underwent ESS and/or septoplasty at a single institution from 2021 to 2022 were enrolled. All patients received postoperative hydrocodone‐acetaminophen for pain control. Half of the patients were also prescribed gabapentin for the first postoperative day in addition to hydrocodone‐acetaminophen. Subjects completed the Revised American Pain Society Patient Outcome Questionnaire 24 h and 7 days after surgery. We conducted a multivariable regression analysis to assess opioid consumption and improvement in pain scores in the first week between gabapentin and non‐gabapentin groups. Results A total of 102 subjects, 51 in each arm, were enrolled. The mean age was 52 years and 53% of participants were female. Controlling for important baseline demographic, clinical, and surgically related variables, the addition of postoperative gabapentin was associated with a 44% (9.5 mg from 21.6 mg) reduction in opioids consumed in the first postoperative week (B = −9.54, 95% C.I. = [−17.84, −1.24], p = 0.025). In addition, patients in both arms exhibited similar improvement in pain severity and sleep interference in the first 7 days (B = −1.59, 95% C.I. = [−5.03, 1.84], p = 0.36). Conclusion To the best of our knowledge, this is the first study to investigate the impact of postoperative gabapentin on opioid consumption and pain control following ESS and/or septoplasty. Our analysis demonstrated that postoperative gabapentin effectively reduced opioid use during the first postoperative week without compromising pain control. Level of Evidence 3 Laryngoscope, 133:1065–1072, 2023

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“…[ 3 ] The use of precisely dosed modern intravenous anesthetic agents, together with proper patient positioning,[ 4 ] allows us to manage hemodynamic parameters during surgery and thus to easily control hemodynamics. [ 5 ] For achieving favorable operative conditions, many drugs such as remifentanil,[ 5 ] propofol, sevoflurane, desflurane,[ 6 ] desmopressin,[ 7 ] dexmedetomidine, clonidine,[ 8 ] and gabapentin[ 9 ] have already been used with varied success rate.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of preoperative flupirtine in ambulatory functional endoscopic sinus surgery: A prospective, double-blind, randomized controlled trial

et al. 2017

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Background:Functional endoscopic sinus surgery (FESS) is the mainstay therapeutic management for nasal pathologies. We evaluated flupirtine, a centrally acting analgesic, for producing perfect perioperative conditions in FESS for adults in a day-care setting.Materials and Methods:Sixty-two patients (25–40 years) scheduled for FESS under general anesthesia were randomly divided into Group F (n = 31) receiving preoperative flupirtine (100 mg) and Group C (n = 31) receiving identical-looking placebo capsule per oral 60 min before induction of anesthesia. Perioperative Nasal bleeding and surgeon's satisfaction score during operation; amount and number of patients receiving fentanyl, propofol, and esmolol infusion for analgesia; maintenance of desired bispectral index (BIS) and deliberate hypotension, respectively. Postanesthesia Care Unit (PACU) and hospital stay, hemodynamic parameters, and side effects were all recorded for each patient.Results:Significantly, less number of patients and less dosage of esmolol were required (P = 0.0040 and 0.0001, respectively) in Group F as compared to that in Group C. Again, number of patients requiring fentanyl and dosage of the same drug was significantly lower in Group F. Dose of propofol for the maintenance of BIS was significantly lower in Group F. However, the duration of controlled hypotension was almost similar in both groups. Group F patients suffered significantly less nasal bleeding and surgeon's satisfaction score was also high in this group. Discharge time from PACU and hospital was similar between two groups without any appreciable side effects.Conclusion:Flupirtine as a premedication found to be providing more favorable perioperative hemodynamic conditions, analgesia and thus allowing less nasal bleeding as well as more surgeons’ satisfaction score.

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Preemptive Analgesic Efficacy of Gabapentin and Nimesulide in the Functional Endoscopic Sinus Surgery

Abstract: Summary Objectives: Preemptive analgesia is an important factor in controlling the

Cited by 8 publications

References 15 publications

A systematic review and meta‐regression analysis of prophylactic gabapentin for postoperative pain

A systematic review and meta‐regression analysis of prophylactic gabapentin for postoperative pain

Postoperative Gabapentin's Effect on Opioid Consumption and Pain Control Following Sinonasal Surgery

Evaluation of preoperative flupirtine in ambulatory functional endoscopic sinus surgery: A prospective, double-blind, randomized controlled trial

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