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BJA Advance Access published online on December 16, 2005
British Journal of Anaesthesia, doi:10.1093/bja/aei294
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2005. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org
Accepted October 23, 2005

Clinical Investigation

Effect of oral gabapentin on postoperative epidural analgesia{dagger}

A. Turan 1 *, G. Kaya 2, B. Karamanlioglu 2, Z. Pamukçu 2, and C. C. Apfel 1

1 Department of Anesthesiology and Perioperative Medicine, University of Louisville, KY 40202, USA; The Outcomes Research Institute, University of Louisville, KY 40202, USA
2 Department of Anaesthesiology, Trakya University, Turkey

* To whom correspondence should be addressed.
A. Turan, E-mail: alparslanturan{at}yahoo.com


  Abstract

Background. Gabapentin has been used successfully as a non-opioid analgesic adjuvant for postoperative pain management. We hypothesized that gabapentin might be a useful adjuvant for postoperative analgesia provided with patient-controlled epidural analgesia (PCEA).

Methods. Forty patients undergoing lower extremity surgery procedures were randomly assigned to receive (i) placebo capsules (control) or (ii) gabapentin (1.2 g day-1) before and for 2 days after surgery. Anaesthetic technique was standardized. Postoperative assessments included verbal rating scale scoring for pain and sedation, PCEA usage, quality of recovery assessment, times of GI function recovery, and patient satisfaction scoring for pain management.

Results. Pain scores at 1, 4, 8, 12, and 16 h (P<0.001), PCEA bolus requirements (n) at 24 [21 (3), 14 (2)], 48 [15 (4), 10 (3)] and 72 [8 (5), 2 (3)] (P<0.05) and paracetamol (mg) consumption [700 (523), 350 (400)]; P<0.05), were significantly lower in the gabapentin-treated patients than in the control group. Patient satisfaction with postoperative pain management at 24 h was better in gabapentin-treated patients [85.5 (7.5), 66.5 (15)]; P<0.001). Gabapentin-treated patients had less motor block when compared with control group. Times of return of bowel function, hospitalization, and resumption of dietary intake were similar in the groups. However, the incidence of dizziness was higher in the gabapentin group (35% vs 5%; P<0.05).

Conclusions. Oral gabapentin (1.2 g day-1) as an adjunct to epidural analgesia decreased pain and analgesic consumption. Despite an increased incidence of dizziness it also increased patient satisfaction.

Keywords: analgesic techniques, epidural; analgesic techniques, regional; analgesics non-opioid, gabapentin; pain, postoperative.
{dagger}This article is accompanied by the Editorial.
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British Journal of Anaesthesia, 8 Feb 2006 [Full text]

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