EFFECT OF PRE-OPERATIVE GABAPENTIN ADMINISTRATION ON INTRAOPERATIVE ANAESTHETIC REQUIREMENTS AND POST-OPERATIVE PAIN SCORES IN PATIENTS UNDERGOING MAJOR ABDOMINAL SURGERY
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Keywords
Gabapentin, Preoperative medication, Anesthetic requirements, Postoperative pain, Major abdominal surgery
Abstract
Introduction: Gabapentin, an anticonvulsant with analgesic properties, has shown promise in perioperative pain management. This study investigated whether preoperative gabapentin reduces intraoperative anesthetic requirements while improving postoperative pain management in patients undergoing major abdominal surgery.
Methods: A prospective, randomized, double-blind, placebo-controlled trial was conducted at Dr. Pinnamaneni Siddhartha Institute of Medical Sciences from July to December 2017. Eighty patients undergoing major abdominal surgery were randomly allocated to receive either gabapentin 600 mg (n=40) or placebo (n=40) orally two hours preoperatively. Primary outcomes included intraoperative sevoflurane consumption, fentanyl requirements, and postoperative Visual Analog Scale pain scores over 24 hours. Secondary outcomes included rescue analgesic consumption, time to first analgesic request, side effects, and patient satisfaction.
Results: Gabapentin significantly reduced intraoperative sevoflurane consumption by 28% (0.42±0.08 vs 0.58±0.12 mL/h/kg, p<0.001) and fentanyl requirements by 38% (2.1±0.6 vs 3.4±0.8 μg/kg, p<0.001). Postoperative pain scores were consistently lower in the gabapentin group throughout 24 hours (p<0.001 at all time points). Total morphine consumption was reduced by 57% (12.4±6.8 vs 28.6±11.4 mg, p<0.001), with prolonged time to first rescue analgesia (4.8±2.1 vs 1.9±0.8 hours, p<0.001). Patient satisfaction scores were higher (8.4±1.6 vs 6.2±2.1, p<0.001) with earlier mobilization and shorter hospital stays. Side effects were mild, primarily sedation and dizziness.
Conclusion: Preoperative gabapentin 600 mg significantly reduces intraoperative anesthetic requirements and provides superior postoperative analgesia in major abdominal surgery, supporting its integration into multimodal perioperative protocols.
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Dr. Manoj Kantilal Parikh
Assistant Professor, Department of Anaesthesia, Dr. Pinnamaneni Siddhartha Institute of Medical Sciences & Research Foundation, Krishna, AP