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Indian Journal of Anesthesia and Analgesia

Volume  6, Issue 5, September-October 2019, Pages 1641-1646
 

Original Article

Outcome of Oral Gabapentin in Total Abdominal Hysterectomies on Post-operative Epidural Analgesia

Thomas P George1, Kiron KG2, Joe Joseph

1Associate Professor, 3Assistant Professor, Pushpagiri Institute of Medical Sciences and Research Centre, Thiruvalla, Kerala 689101, India. 2Consultant, St Thomas Hospital, Chethpuzha, Changanassery, Kerala 686104, India.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6519.23

Abstract

Background: Pre-emptive analgesia is defined as an anti-nociceptive treatment that prevents the establishment of altered central processing of afferent input, which amplifies post-operative pain. Objective: To evaluate the role of gabapentin as pre-emptive analgesic in patients undergoing total abdominal hysterectomy. Methods: Aprospective, randomized clinical study was conducted and the patients were randomly allocated to two groups of 15 each with ASA Grade I and II. Patients in Group A were given oral gabapentin 1200 mg 1 hour before surgery whereas placebo was given to patients belonging to Group B. Epidural block is achieved in both groups with a bolus dose of 0.5% bupivacaine (maximum allowable dose–2 mg/kg) prior to surgery. After skin closure, the infusion dose is reduced to a lower concentration of Bupivacaine (0.0625% ) at the rate of 2 ml/hr and the patient will be shifted to HDU (high dependency unit). Data collected includes patients age, body weight, post-operative VAS scores, and tramadol 50 mg I.V. doses given at 1, 4, 8, 12, 16, 20, 24 hours. Results: Study revealed that the mean VAS score in the post-operative period is lower in group A (Gabapentin) as compared to group B (placebo). Mean number of total top ups with tramadol is lower in Group A (Gabapentin) as compared to Group B (Placebo). Conclusion: Pre-emptive use of gabapentin 1200 mg orally significantly reduces the number of post-operative analgesic dose requirements and post-operative pain in patients undergoing total abdominal hysterectomy under epidural anesthesia.


Keywords : Gabapentin; Total abdominal hysterectomy; Pre-emptive analgesia.
Corresponding Author : Kiron KG