EFFICACY AND SAFETY OF PREEMPTIVE GABAPENTIN VERSUS PLACEBO FOR MANAGEMENT OF POSTOPERATIVE PAIN IN PATIENTS UNDERGOING SPINE SURGERY
Hannaa F. Salama, Sherin A. mohamed, Wafaa Z. El Morsy
Department of Anaesthesia and Intensive careFaculty of Medicine, Al Azhar University for girls
Background: Gabapentin is an antiepileptic drug approved for treatment of neuropathic pain and recently, it has a place in the treatment of acute postoperative pain. In the current study we compare the efficacy and safety of preemptive gabapentin versus placebo for management of acute postoperative pain after elective spine surgery. Method: 40 ASA M or patients were randomly allocated to two groups to receive either 600mg gabapentin or placebo two hours before surgery under general anesthesia. Postoperatively, The level of sedation was assessed. The pain was assessed on a visual analogue scale (VAS) at extubation (0 hour) and at 2, 4, 6, 12 and 24 hours after surgery. Rescue analgesia (morphine 0.05mg/kg) was used to treat postoperative pain when VAS was above 3. Mean time to first request for analgesia, average numbers of morphine doses as well as total morphine consumption in the first 24 hours after surgery was recorded. Side effects including postoperative nausea, vomiting dizziness and headache were also recorded.Results: Patients in the gabapentin group has significantly lower VAS scores at all time intervals at 0, 2, 4, 6, 12 and 24 hours after surgery. Postoperative sedation scores were significantly higher in gabapentin group in comparison to placebo group within the first four hours postoperatively (Pt0.05). After four hours, till 24 hours postoperatively, there were no statistically significant differences among the two groups (Pf0.05). The average numbers of rescue doses of morphine, the mean time to first request of analgesia and mean supplemental morphine consumption were significantly lower in gabapentin group as compared to placebo group. The incidence of vomiting and urinary retention was significantly (Pp0.05) higher in the placebo group, but there was no difference in incidence of other adverse effects between the groups. Conclusion: Preemptive gabapentin decreased pain scores in the early postoperative period and postoperative morphine consumption in patients undergoing spine surgery and decreased some morphine-associated side effects.