Abstract
Purpose
We investigated the effects of pre-incision and postincision administration of gabapentin on postoperative pain and fentanyl consumption associated with open donor nephrectomy.
Methods
Sixty ASA I subjects were randomly allocated into three groups to receive gabapentin 600 mg two hours before surgery and placebo after surgical incision (pre-incision group), placebo two hours before surgery and gabapentin 600 mg after surgical incision (post-incision group), or placebo two hours before surgery and after surgical incision (placebo group). After surgery, pain was assessed using a visual analogue scale (VAS), (1-10 cm) at time points 0, 6, 12, 18, and 24 hr. Subjects received patient-controlled-analgesia (fentanyl 1.0 μg·kg-1 subject activated dose). Total fentanyl consumption in each group was recorded.
Results
Subjects of pre-incision and post-incision groups had lower VAS scores at all time points (3.1 ± 1.8, 2.9 ± 1.3, 2.8 ± 1.3, 2.5 ± 0.9, 2.5 ± 1.5 and 3.6 ± 1.1, 3.0 ± 1.2, 3.2 ± 1.1, 2.9 ± 1.0, 2.6 ± 2.2) compared to placebo group (6.6 ± 1.3, 5.0 ± 1.0, 4.4 ± 0.7, 4.2 ± 0.8, 3.9 ± 1.0). They also used less fentanyl (563.3 μg ± 252.8 and 624.0 μg ± 210.5 respectively) compared to placebo (924.7 μg ± 417.5), (P < 0.05). No difference in total fentanyl consumption and pain scores at any time points were observed between pre- and post-incision groups.
Conclusion
Pre-incision administration of 600 mg gabapentin has no added benefit over post-incision administration in terms of pain scores and fentanyl consumption in subjects undergoing open donor nephrectomy.
Résumé
Objectif
Nous avons vérifié les effets de la gabapentine, administrée avant ou après ľincision, sur la douleur postopératoire de même que la consommation de fentanyl lors ďune néphrectomie chez un donneur vivant.
Méthode
Soixante sujets ďétat physique ASA I, répartis au hasard en trois groupes, ont reçu 600 mg de gabapentine deux heures avant ľopération et un placebo après ľincision chirurgicale (groupe pré-incision), un placebo deux heures avant ľopération et 600 mg de gabapentine après ľincision (groupe post-incision) ou un placebo deux heures avant ľopération et après ľincision (groupe placebo). La douleur postopératoire a été évaluée par une échelle visuelle analogique (EVA), de 1 à 10 cm à 0, 6, 12, 18 et 24 h. Les sujets ont eu une analgésie auto-contrölée en doses de 1,0 μg·kg-1. La consommation totale de fentanyl de chaque groupe a été notée.
Résultats
Les sujets des groupes pré-incision et post-incision ont présenté les scores les plus bas à ľEVA, pour toutes les mesures (3,1± 1,8; 2,9 ± 1,3; 2,8 ± 1,3; 2,5 ± 0,9; 2,5 ± 1,5 et 3,6 ± 1,1; 3,0± 1,2; 3,2 ± 1,1; 2,9 ± 1,0; 2,6 ± 2,2), comparativement au groupe placebo (6,6 ± 1,3; 5,0 ± 1,0; 4,4 ± 0,7; 4,2 ± 0,8; 3,9 ± 1,0). Ils ont aussi utilisé moins de fentanyl (563,3 μg ± 252,8 et 624,0 μg ± 210,5 respectivement) que le groupe placebo (924,7 μg ± 417.5), (P < 0,05). Aucune différence de consommation totale de fentanyl et de scores de douleur n’a été observée entre les groupes pré-incision et post-incision.
Conclusion
Ľadministration pré-incision de 600 mg de gabapentine n’a pas ďavantage sur ľadministration post-incision quant aux scores de douleur et à la consommation de fentanyl chez des donneurs vivants qui subissent une néphrectomie.
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Pandey, C.K., Singhal, V., Kumar, M. et al. Gabapentin provides effective postoperative analgesia whether administered pre-emptively or post-incision. Can J Anesth 52, 827–831 (2005). https://doi.org/10.1007/BF03021777
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DOI: https://doi.org/10.1007/BF03021777