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Preemptive gabapentin reduces postoperative pain and opioid demand following thyroid surgery

[L’administration préventive de gabapentine réduit la douleur postopératoire et la demande d’opioïdes à la suite d’une thyroïdectomie]

From the Department of Anesthesia and Intensive Care, Al-Sabah Hospital, Safat, Kuwait.

Address correspondence to: Dr. Yatindra Kumar Batra, Department of Anaesthesia and Intensive Care Unit, Post-Graduate Institute of Medical Education & Research, Chandigarh, India. Fax: +91-172-2744401; E-mail: ykbatra{at}glide.net.in

Purpose: Gabapentin is reported to possess antihyperalgesic and antiallodynia properties. Recently, reports have indicated that gabapentin may have a place in the treatment of postoperative pain. In this study, we sought to determine whether preemptive use of gabapentin reduced postoperative pain and morphine demand following thyroidectomy.

Methods: In this prospective, randomized, double-blind clinical trial, we gave gabapentin 1200 mg or placebo two hours prior to induction of anesthesia to patients undergoing elective thyroidectomy. Post-thyroidectomy pain was assessed on a visual analogue scale at rest and during swallowing in the first 24 hr postoperatively. All patients received morphine 3 mg iv every five minutes until visual analogue scale scores were 4 or less at rest, and 6 or less with swallowing. Total morphine consumption for each patient was recorded from zero to 24 hr postoperatively.

Results: Thirty-seven patients in the gabapentin group and 35 patients in the placebo group completed the study. Overall, pain scores at rest and during swallowing in the gabapentin group were significantly lower when compared with the placebo group. Total postoperative morphine consumption in the gabapentin group was 15.2 ± 7.6 mg (mean ± SD) vs 29.5 ± 9.9 mg in the placebo group (P < 0.001). No significant differences in side effects were observed between groups.

Conclusions: Preoperative gabapentin decreased pain scores and postoperative morphine consumption in patients following thyroid surgery.

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