The effect of gabapentin on reducing pain after laparoscopic gastric bypass surgery in patients with morbid obesity: a randomized clinical trial

Valiollah Hassani, Abdolreza Pazouki, Nasim Nikoubakht, Shahla Chaichian, Azadeh Sayarifard, Ali Shakib Khankandi, Valiollah Hassani, Abdolreza Pazouki, Nasim Nikoubakht, Shahla Chaichian, Azadeh Sayarifard, Ali Shakib Khankandi

Abstract

Background: Pain after laparoscopic gastric bypass surgery (LGBP) is a major problem. Gabapentin is an anticonvulsant drug that can be effective in postoperative pain control.

Objectives: This study examined the effect of preoperative administration of gabapentin on reducing pain after LGBP in patients with morbid obesity.

Patients and methods: This randomized clinical trial was performed in Hazrat Rasoul Akram Medical Center in Tehran. A total of 60 patients undergoing LGBP were randomly allocated into two groups; one group received 100 mg of oral gabapentin and the other group received placebo. Pain was evaluated at recovery time, and at the first, second, fourth and sixth hour of surgery by visual analog scale. The number and dose of opioid use after surgery and incidence of postoperative complications, such as nausea and vomiting, agitation, and headache, were also recorded.

Results: The mean pain score in the group receiving gabapentin was significantly lower than the placebo group (P < 0.001). Indications and dose of opioid consumption between the two groups were not statistically significant. Incidence of nausea/vomiting (P = 0.028) as well as agitation (P = 0.037) was significantly lower in the gabapentin group.

Conclusions: Administration of gabapentin before surgery can reduce pain after LGBP. Furthermore, it is not accompanied by significant short-term adverse effects.

Keywords: Gabapentin; Morbid Obesity; Postoperative Pain; laparoscopic Gastric Bypass Surgery.

Figures

Figure 1.. Flow Diagram of Patients in…
Figure 1.. Flow Diagram of Patients in the Trial
Figure 2.. Comparison of the Mean of…
Figure 2.. Comparison of the Mean of Visual Analog Scale in Gabapentin and Placebo Groups
Abbreviation: VAS, visual analog scale.

References

    1. Formiguera X, Canton A. Obesity: epidemiology and clinical aspects. Best Pract Res Clin Gastroenterol. 2004;18(6):1125–46. doi: 10.1016/j.bpg.2004.06.030.
    1. Gooren L. Obesity: new aspects. J Mens Health. 2008;5(3):249–56. doi: 10.1016/j.jomh.2008.07.002.
    1. Kelishadi R, Alikhani S, Delavari A, Alaedini F, Safaie A, Hojatzadeh E. Obesity and associated lifestyle behaviours in Iran: findings from the First National Non-communicable Disease Risk Factor Surveillance Survey. Public Health Nutr. 2008;11(3):246–51. doi: 10.1017/S1368980007000262.
    1. Esteghamati A, Khalilzadeh O, Mohammad K, Meysamie A, Rashidi A, Kamgar M, et al. Secular trends of obesity in Iran between 1999 and 2007: National Surveys of Risk Factors of Non-communicable Diseases. Metab Syndr Relat Disord. 2010;8(3):209–13. doi: 10.1089/met.2009.0064.
    1. Hossain P, Kawar B, El Nahas M. Obesity and diabetes in the developing world--a growing challenge. N Engl J Med. 2007;356(3):213–5. doi: 10.1056/NEJMp068177.
    1. Mello MM, Studdert DM, Brennan TA. Obesity--the new frontier of public health law. N Engl J Med. 2006;354(24):2601–10. doi: 10.1056/NEJMhpr060227.
    1. DeMaria EJ. Bariatric surgery for morbid obesity. N Engl J Med. 2007;356(21):2176–83. doi: 10.1056/NEJMct067019.
    1. Balsiger BM, Poggio JL, Mai J, Kelly KA, Sarr MG. Ten and more years after vertical banded gastroplasty as primary operation for morbid obesity. J Gastrointest Surg. 2000;4(6):598–605.
    1. Kilgore TR, Tichansky DS, Madan AK. In patient pain management after laparoscopic gastric bypass. Bariatr Surg Pract Patient Care. 2008;3(2) doi: 10.1089/bar.2008.9975.
    1. Barth MM, Jenson CE. Postoperative nursing care of gastric bypass patients. Am J Crit Care. 2006;15(4):378–87.
    1. Schauer PR, Schirmer BD, Brethauer SA. Minimally Invasive Bariatric Surgery. New York: Springer; 2007.
    1. Rahimzadeh P. Gabapentinoids in Pain Setting. J Pain Relief. 2013;2 doi: 10.4172/2167-0846.1000e114.
    1. Mathiesen O, Moiniche S, Dahl JB. Gabapentin and postoperative pain: a qualitative and quantitative systematic review, with focus on procedure. BMC Anesthesiol. 2007;7:6. doi: 10.1186/1471-2253-7-6.
    1. Alimian M, Imani F, Hassani V, Rahimzadeh P, Sharifian M, Safari S. Effects of single-dose pregabalin on postoperative pain in dacryocystorhinostomy surgery. Anesth Pain Med. 2012;2(2):72–6.
    1. Imani F, Hasani V, Bazargani B, Entezari SR, Mirdehghan MH. Evaluation of oral gabapentin premedication on postoperative pain after thoracotomy. Razi J Med Sci. 2009;16(62):73–9.
    1. Pasero C. Assessment of sedation during opioid administration for pain management. J Perianesth Nurs. 2009;24(3):186–90. doi: 10.1016/j.jopan.2009.03.005.
    1. Chang CY, Challa CK, Shah J, Eloy JD. Gabapentin in acute postoperative pain management. Biomed Res Int. 2014;2014:631756. doi: 10.1155/2014/631756.
    1. Kavoussi R. Pregabalin: From molecule to medicine. Eur Neuropsychopharmacol. 2006;16 Suppl 2:S128–33. doi: 10.1016/j.euroneuro.2006.04.005.
    1. Shneker BF, McAuley JW. Pregabalin: a new neuromodulator with broad therapeutic indications. Ann Pharmacother. 2005;39(12):2029–37. doi: 10.1345/aph.1G078.
    1. Lee JH, Lee HK, Chun NH, So Y, Lim CY. The prophylactic effects of gabapentin on postoperative sore throat after thyroid surgery. Korean J Anesthesiol. 2013;64(2):138–42. doi: 10.4097/kjae.2013.64.2.138.
    1. Ajori L, Nazari L, Mazloomfard MM, Amiri Z. Effects of gabapentin on postoperative pain, nausea and vomiting after abdominal hysterectomy: a double blind randomized clinical trial. Arch Gynecol Obstet. 2012;285(3):677–82. doi: 10.1007/s00404-011-2023-6.
    1. Panah Khahi M, Yaghooti AA, Marashi SH, Nadjafi A. Effect of pre-emptive gabapentin on postoperative pain following lower extremity orthopaedic surgery under spinal anaesthesia. Singapore Med J. 2011;52(12):879–82.
    1. Ture H, Sayin M, Karlikaya G, Bingol CA, Aykac B, Ture U. The analgesic effect of gabapentin as a prophylactic anticonvulsant drug on postcraniotomy pain: a prospective randomized study. Anesth Analg. 2009;109(5):1625–31. doi: 10.1213/ane.0b013e3181b0f18b.
    1. Hurley RW, Cohen SP, Williams KA, Rowlingson AJ, Wu CL. The analgesic effects of perioperative gabapentin on postoperative pain: a meta-analysis. Reg Anesth Pain Med. 2006;31(3):237–47. doi: 10.1016/j.rapm.2006.01.005.
    1. Dauri M, Faria S, Gatti A, Celidonio L, Carpenedo R, Sabato AF. Gabapentin and pregabalin for the acute post-operative pain management. A systematic-narrative review of the recent clinical evidences. Curr Drug Targets. 2009;10(8):716–33.
    1. Dierking G, Duedahl TH, Rasmussen ML, Fomsgaard JS, Moiniche S, Romsing J, et al. Effects of gabapentin on postoperative morphine consumption and pain after abdominal hysterectomy: a randomized, double-blind trial. Acta Anaesthesiol Scand. 2004;48(3):322–7. doi: 10.1111/j.0001-5172.2004.0329.x.
    1. Clivatti J, Sakata RK, Issy AM. Review of the use of gabapentin in the control of postoperative pain. Rev Bras Anestesiol. 2009;59(1):87–98.
    1. Turan A, Karamanlioglu B, Memis D, Hamamcioglu MK, Tukenmez B, Pamukcu Z, et al. Analgesic effects of gabapentin after spinal surgery. Anesthesiology. 2004;100(4):935–8.
    1. Sen H, Sizlan A, Yanarates O, Emirkadi H, Ozkan S, Dagli G, et al. A comparison of gabapentin and ketamine in acute and chronic pain after hysterectomy. Anesth Analg. 2009;109(5):1645–50. doi: 10.1213/ANE.0b013e3181b65ea0.

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