The Analgesic Effects of Gabapentin After Total Abdominal Hysterectomy

Abstract

This randomized, controlled trial examined the effects of preoperative oral gabapentin 1200 mg on postoperative pain and tramadol consumptions. We conclude that preoperative oral gabapentin is effective in reducing postoperative pain scores and tramadol consumption in patients after abdominal hysterectomy.

Preoperative gabapentin for postoperative analgesia: a meta-analysis

“…Of the 333 patients who received gabapentin, 62 received multiple dosing, 19,21 and the rest received single doses prior to surgery. The surgeries included abdominal hysterectomy, 21,22 radical mastectomy or lumpectomy, 19,23 vaginal hysterectomy, 17 laparoscopic cholecystectomy 18 and lumbar discectomy or spinal fusion. 24,25 Due to the nature of the surgeries, four of the trials evaluated female patients only.…”

“…17,18,22,24,25 This difference was most pronounced at 12-18 hr postoperatively. While the study by Fassoulaki et al, 19 which measured pain at rest as well as pain on mobilization, found no significant difference in visual analogue scale scores at rest during the first 24 hr postoperatively, it did find significantly lower resting pain scores in the gabapentin group by the third postoperative day.…”

“…All studies which evaluated pain scores on mobilization 19,[21][22][23] showed a statistically significant reduction in pain scores during the first 24 hr postoperatively (WMD 11.0; 95% CI 6.7-15.3), (Figure 1). The meta-analysis demonstrated that the use of gabapentin was associated with lower postoperative pain scores, with this difference being particularly pronounced at 12-18 hr postoperatively (WMD 15.9; 95% CI 7.1-24.7), (Figure A, available as Additional Material at www.cja-jca.org).…”

la gabapentine fournit une analgésie postopératoire efficace, qu’elle soit administrée avant ou après ľincision

“…In animal models of nociception, gabapentin reduces hypersensitivity associated with nerve injury, inflammation, and pain after surgery. [3][4][5] It has been proposed that mechanical hyperalgesia surrounding the wound in postoperative subjects, and experimental heat-induced secondary hyperalgesia share a common mechanism (central neuronal sensitization) that may contribute to, and amplify postoperative pain, though the relative contribution of various pain mechanisms to postoperative pain has not been established. 3,6 Antihyperalgesic drugs (such as gabapentin) may have a role in prevention of postoperative pain, and the combination with other antinociceptive drugs may produce synergistic analgesic effects.…”

“…[3][4][5] It has been proposed that mechanical hyperalgesia surrounding the wound in postoperative subjects, and experimental heat-induced secondary hyperalgesia share a common mechanism (central neuronal sensitization) that may contribute to, and amplify postoperative pain, though the relative contribution of various pain mechanisms to postoperative pain has not been established. 3,6 Antihyperalgesic drugs (such as gabapentin) may have a role in prevention of postoperative pain, and the combination with other antinociceptive drugs may produce synergistic analgesic effects. 7 As gabapentin enhances the analgesic effects of morphine in healthy volunteers and the combination produces better analgesia in comparison with morphine alone, 8 the drug may exert a selective effect on the nociceptive process involved in central neuronal sensitization, and is the rationale for its use in the treatment of acute postoperative pain.…”