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Effect of a Preoperative Gabapentin on Postoperative Analgesia in Patients with Inflammatory Bowel Disease Following Major Bowel Surgery: A Randomized, Placebo‐Controlled Trial
Author(s) -
Siddiqui Naveed T.,
Fischer Howard,
Guerina Laarni,
Friedman Zeev
Publication year - 2014
Publication title -
pain practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 58
eISSN - 1533-2500
pISSN - 1530-7085
DOI - 10.1111/papr.12058
Subject(s) - medicine , gabapentin , inflammatory bowel disease , placebo , anesthesia , randomized controlled trial , surgery , disease , alternative medicine , pathology
Abstract Background Postoperative pain management for patients with inflammatory bowel disease ( IBD ) can be challenging. These patients have a high tolerance to pain medication, and relative contraindications to the use of epidural analgesia, limiting the pain management options. We evaluated the effect of a single preoperative gabapentin dose on opioid consumption for patients with IBD undergoing abdominal surgery. Secondary outcomes were postoperative pain scores, opioid‐related side effects, and patient's length of hospital stay. Methods Following Research Ethics Board approval and informed written consent, patients were randomly allocated into 2 groups receiving either 600 mg of oral gabapentin or placebo 1 hour before the surgery. A blinded anesthesiologist recorded pain scores at rest and movement twice daily for 2 postoperative days. Also recorded were opioid consumption, time of return of bowel function, time to discharge, and opioid‐related side effects on the opioid‐related symptom distress scale ( ORSDS ). Results Seventy‐two patients completed the study. The difference in opioid consumption ( P = 0.4169) and pain scores measured at rest and movement on all 4 postoperative visits was not statistically significant. There was no significant difference between gabapentin and placebo on all the 11 symptoms reported on the ORSDS . There was a slight increase in length of hospital stay in the placebo group, but the return of bowel function was similar between the groups. Conclusions This study examined the effect of a single preoperative administration of gabapentin in patients with IBD undergoing major bowel surgery. Our results suggest a single preoperative oral dose of gabapentin 600 mg does not reduce postoperative pain scores, opioid consumption, or opioid‐related side effects.