Effect of gabapentin on opioid requirements in patients undergoing total abdominal hysterectomy

Abstract

Introduction: Gabapentin possesses antihyperalgesic and antiallodynia properties and has a definite role in neuropathic
pain relief. In this study, we tried to determine whether preemptive use of gabapentin can result in reduction of intra and
postoperative pain and narcotic (nalbuphine) requirements in patients undergoing total abdominal hysterectomy (TAH).
Methods: In this randomized, double-blind controlled trial, 35 patients (study group) undergoing TAH received
gabapentin 1200 mg and 35 patients (control group) received placebo orally two hours before induction of anesthesia.
Intra-operatively, an increase in blood pressure and heart rate were taken as an indicator of pain during surgery and
nalbuphine at 0.05-mg/kg body weight was administered as a rescue analgesia. Postoperatively, for the initial 24 hours,
pain was assessed on a Visual Analogue Scale (VAS score 1-10, score 1-3 considered mild pain, 4-7 moderate pain &
8-10 as severe pain). If score was more than 3 a top up dose of nalbuphine 0.05 mg/kg was administered intravenously.
Total nalbuphine consumption during the intraoperative period and initial 24 hours postoperative period was recorded
for each patient.
Results: Thirty four patients in the gabapentin group (study group) and 35 patients in the Placebo group (control group)
completed the study. Overall, pain scores in the gabapentin group were significantly lower as compared to the Placebo
group. The total nalbuphine consumption was 13.2 ± 4.7 mg (mean ± SD) in the gabapentin group versus 24.3 ± 9.2
mg in the Placebo group (P < 0.001).
Conclusions: Preemptive use of gabapentin resulted in reduction of intra and postoperative narcotic (Nalbuphine)
requirements in patients undergoing total abdominal hysterectomy