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To Evaluate the Role of Gabapentin as Preemptive Analgesic in Patients Undergoing Total Abdominal Hysterectomy in Epidural Anaesthesia
oleh: Anil Verma, Sangeeta Arya, Sandeep Sahu, Indu Lata, H D Pandey, Harpreet Singh
Format: | Article |
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Diterbitkan: | Wolters Kluwer Medknow Publications 2008-01-01 |
Deskripsi
Gabapentin, a structural analogue of gamma-amino butyric acid, has been used as an anticonvulsant and antinociceptive drug but its mode of action is not well understood. Gabapentin has been demonstrated in various clinical studies to be of value as preemptive analgesic, and has shown to reduce the postoperative requirement of opioids. This study was conducted to evaluate the role of gabapentin as preemptive analgesic in patients undergoing total abdominal hysterectomy. Fifty patients with ASA grade I and II were assigned to receive 300mg gabapentin or placebo 2hr before surgery. Surgeries were conducted under combined spinal epidural anaesthesia. Post operatively, pain was assessed by visual analogue score (VAS) at 2, 4,8,12 and 24hrs. Patients were given epidural boluses of bupivacaine (0.125%) on demand. Total numbers of epidural boluses during first 24 hrs postoperatively were noted. Patients in gabapentin group have significantly lower VAS score 2, 4,8,12 and 24hrs postoperatively as compared to the placebo (1.3 ± 1.3, 2.3±1.4, 3.2 ± 2.1, 1.8 ± 1.7, 1.2 ± 1.3 vs. 2.1 ± 1.7, 3.2±1.6, 4.4 ± 1.2, 3.3 ± 1.1, 2.1 ± 1.2 respectively; P < 0.05). Total numbers of epidural boluses were significantly less in gabapentin group (3.4±1.6 vs. 5.6±2.1, P< 0.05). We conclude that preemptive use of gabapentin 300mg orally significantly reduces the number of postoperative epidural bolus requirement and postoperative pain in patients undergoing total abdominal hysterectomy under combined spinal epidural anaesthesia.