Effect of Pre-Operative Gabapentin on Early Post-Operative Pain, Nausea, Vomiting and Analgesic Consumption Following Cholecystectomy in a Tertiary Level Hospital

Analgesics, Cholecystectomy, Gabapentin, Post-operative pain.Introduction: Post operative pain is the greatest fear of patients who undergo any surgical procedure. Gabapentin is not normally used to treat pain due to injury or pain after an operation. Presently available data suggest that pre-operative gabapentin may play role in the management of post operative pain but more work is necessary before recommending it for routine clinical use. Methods: A randomised control trial was conducted among 80 patients (40 each in each group) undergoing elective cholecystectomy to determine the effect of pre operative single dose Gabapentin 300 mg on post operative pain and analgesic consumption. Severity of pain, nausea, vomiting and total analgesic consumption was compared between the two study groups after operation. Results: In placebo group postoperatively the pain score (Mean ± SEM) in VAS at 2, 6,&24 hrs was (57.0 ± 1.7), (43.5 ± 1.7), (34.2 ± 3.0) respectively. But statistically significant less pain score (39.7 ± 2.0) (p < 0.001), (25.5 ± 2.0) (p < 0.001), (23.2 ± 3.1) (p < 0.05) was observed in Gabapentin group at 2, 6,&24 hrs respectively. Postoperatively the total dose of analgesic consumption in Gabapentin group was (0.90 ± 0.04, 1.2 ± 0.7, 1.6 ± 0.12) respectively in 2, 6&24 hrs post operatively. Whereas in the placebo group the total number of dose of analgesic consumption was (1.0 ± 0.00), (1.8 ± 0.07), (2.50 ± 0.13) at 2, 6 and 24 hour respectively which were statistically higher than gabapentin group. Except nausea at 24 hour postoperatively there was no statistically significant difference of nausea and vomiting between the two groups. No patient in any group reported any adverse effect like somnolence, ataxia, lightheadedness, pruritus or visual disturbances. Conclusion: This study suggests that gabapentin has clinical potential in management of post operative pain. So gabapentin can be safely used in low dose (300 mg) as a preemptive analgesic before start of cholecystectomy.