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Pre-emptive use of gabapentin 600 mg orally, significantly decreases postoperative pain and PONV, and also rescues analgesic and anti emetic drug requirements in patients who undergo abdominal hysterectomy. Gabapentin and the related, more potent compound pregabalin have been shown to be beneficial in the treatment of neuropathic pain as well as postoperative pain following spinal surgery and hysterectomy. The primary outcome is prolonged use of gabapentin in the postoperative period, defined as a prescription refilled at 90-180 days after discharge from surgery, a time period based on definitions of prolonged use of opioids after surgical procedures. 20,25,26 We calculated the days’ supply and average daily dose. We defined which procedures A significant number of RCTs have demonstrated conflicting results in the use of preoperative gabapentin. 19 Bharti et al 20 studied gabapentin administration among patients (n=40) undergoing mastectomy (20 received gabapentin and 20 received placebo) and demonstrated a reduction in the amount of morphine required during the initial 24 hours 1. Introduction. The “Guidelines for Pre- and Intra-operative Care in Gynecologic/Oncology Surgery: Enhanced Recovery After Surgery (ERAS®) Society Recommendations — Part I,” [] examined the evidence surrounding care elements including preoperative medical optimization, bowel preparation, carbohydrate loading, thromboembolism prophylaxis, skin preparation, standard anesthetic protocol Use of preemptive paracetamol, gabapentin, bupivacaine, and phenothiazine resulted in less narcotic usage than placebo. All narcotics (ketamine, morphine, fentanyl) resulted in improved pain control compared with placebo. Similarly, aside from 24 h after surgery, gabapentin significantly reduced pain with movement (25–27,31,34,35,37,38) by 18% to 28% (VAS 8.2 mm to 10.2 mm) after surgery . The pooled effects on VAS pain scores displayed significant heterogeneity, which was not explained by subgroup analyses based on surgical procedure, gabapentin dose or study Postoperative pain is an important factor affecting anesthesia and surgery. The present study assessed the effects of 1200 mg gabapentin, an anticonvulsant drug that acts through voltage-dependent calcium channels, for the control of postoperative pain in patients undergoing abdominal hysterectomy. We investigated, in a randomized, placebo-controlled, double-blind study, the efficacy and safety of gabapentin on pain after abdominal hysterectomy and on tramadol consumption in patients. The 50 patients were randomized to receive either oral placebo or gabapentin 1200 mg 1 h before surgery. Ajori L, Nazari L, Mazloomfard MM, Amiri Z. Effects of gabapentin on postoperative pain, nausea and vomiting after abdominal hysterectomy: a double blind randomized clinical trial. Arch Gynecol Obstet. 2012;285(3):677–82. doi: 10.1007/s00404-011-2023-6. The primary outcome assessed was the total amount of narcotics used at 24 hours after surgery. Secondary outcomes included adverse effects from gabapentin use, total narcotics used, and pain scores at 2 weeks after surgery. We investigated, in a randomized, placebo-controlled, double-blind study, the efficacy and safety of gabapentin on pain after abdominal hysterectomy and on tramadol consumption in patients. The 50 patients were randomized to receive either oral placebo or gabapentin 1200 mg 1 h before surgery. Gabapentin adverse effects at 2 weeks after surgery. This graph notes the percentages of patients who reported experiencing the list of potential gabapentin adverse effects (x-axis) within 2 weeks after surgery. Participants in the gabapentin arm are represented by the dark gray color; those in the control are represented by the light gray color. Frouzanfard et al. gave gabapentin 1200 mg to a group of hysterectomy candidates and placebo to the other group, 2 hours before the surgery. Pain and required morphine in the gabapentin group decreased significantly, similar to our study. Conclusion: Gabapentin 600 mg administered 1 hr before laparoscopic abdominal surgery is as effective as gabapentin 900 mg for PONV control and VAS reduction of 24-hour postoperative pain scores with fewer side effects. On the other hand, gabapentin 300 mg did not demonstrate good control of PONV, or pain control compared to higher doses. This is the first systematic review with focus on procedure-specific effects of gabapentin in postoperative pain, and we have demonstrated that preoperative gabapentin reduces 24-hour postoperative opioid consumption for patients in abdominal hysterectomy and spinal surgery. However, perioperative gabapentin had a significant effect on promoting opioid cessation after surgery. MeaningSeventy-two hours of perioperative gabapentin use may promote opioid cessation after surgery and decrease the duration of postoperative opioid use. Metaregression analysis showed that the effect of gabapentin in reducing morphine consumption (compared with placebo) at 24 hours was stronger in the preoperative only group than in the preoperative and postoperative groups. ABSTRACT: Gynecologic surgery is very common: hysterectomy alone is one of the most frequently performed operating room procedures each year. It is well known that surgical stress induces a catabolic state that leads to increased cardiac demand, relative tissue hypoxia, increased insulin resistance, impaired coagulation profiles, and altered pulmonary and gastrointestinal function. Their findings, recently published in the journal Anesthesiology, indicate that the analgesic benefits of pregabalin and gabapentin after surgery are negligible, regardless of the dose or type of operation. Gabapentinoids were also ineffective in preventing chronic pain from developing after surgery, one of the primary justifications for using
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