USE OF ORAL GABAPENTIN AS PREEMPTIVE ANALGESIA TO ATTENUATE POST OPERATIVE PAIN IN PATIENTS UNDERGOING SPINE SURGERY

Dr  Atul B. Vyas; Dr. Anuja Thakkar; Dr. Ankit D. Desai; Dr. Vimal Dave; Dr. Shivam Dhar

Volume : V, Issue : XII, December - 2015

USE OF ORAL GABAPENTIN AS PREEMPTIVE ANALGESIA TO ATTENUATE POST OPERATIVE PAIN IN PATIENTS UNDERGOING SPINE SURGERY

Dr Atul B. Vyas, Dr. Anuja Thakkar, Dr. Ankit D. Desai, Dr. Vimal Dave, Dr. Shivam Dhar

Abstract :

Background and aims: Pain is a common postoperative symptom impairing the quality of postoperative recovery, delaying discharge from Post–anaesthesia care unit (PACU) or surgical centre.The aims and objectives of present study were 1. To study the safety and efficacy of preoperative single oral dose of gabapentin for post–operative analgesia after Spine surgery. 2. To study the other effects and side effects of oral gabapentin. Methods:80 ASA (American Society of Anaesthesiologists) I or II patients aged 18–70 years scheduled for elective Spine surgery under general anaesthesia were recruited for the comparative study. The patients were assigned randomly into either of following two groups with each group including 40 patients. Group A (gabapentin group): All patients were given Oral Gabapentin 600 mg 1 hour before surgery and Group B (control): placebo in the form of glucose capsule. Postoperative pain was analyzed by Severity of postoperative pain by Visual Analogue Score(VAS), Postoperative hemodynamic changes, Time of rescue analgesic, Post–operative complications Results: Group A, 3(7.5%) patients required only one rescue analgesic dose in the post–operative period, 30(75%) patients required 2 doses, only 7(17.5%) patients required 3 rescue analgesic doses and No patient required 4 doses. While in Group B No patient satisfied with one rescue analgesic dose in the post–operative period, 2(5%) patients required 2 doses, 25(62.5%) patient required 3 rescue analgesic doses and 13(31%) patients required 4 rescue analgesic doses.Mean VAS score in Group A is significantly less than Group B over 24 hours of postoperative period and it is statistically significant (p value<0.005).Mean intra operative heart rate and Blood pressure in Group A is lower than Group B throughout the intra operative period after intubation with statistical significance (p<0.05). Conclusions: Gabapentin reduced the need for additional postoperative pain treatment (PCA boluses of 50 microg of fentanyl) by 40% during the first 20 postoperative hours.Pre–treatment with gabapentin reduced the degree of postoperative nausea and incidence of vomiting/retching possibly either due to the diminished need for postoperative pain treatment with opioids or because of an anti–emetic effect of gabapentin itself.