Background: Postoperative pain, nausea, and vomiting are frequent and unpleasant adverse events associated with surgery. The reported incidence of postoperative nausea and vomiting after laparoscopic cholecystectomy (LC) is quite high. Recently, studies have been undertaken to determine the role of gabapentin for the prevention of postoperative pain, nausea, and vomiting.
Objective: To evaluate the effects of oral gabapentin on early postoperative pain, nausea, and vomiting in patients undergoing LC.
Materials and Methods: A total of 40 patients scheduled to undergo LC were enrolled for this double-blind placebo-controlled study. Patients were divided into two groups of 20 patients each. Group A received two doses of 600 mg (300 mg ± 2 tablets) gabapentin: first dose 2 h before surgery and second dose 6 h after surgery. Group B received matching placebo (tablets) of same size and shape as gabapentin tablets. All patients were observed for postoperative pain, nausea, and vomiting on first and second postoperative days. In addition, pulse rate and systolic and diastolic blood pressures were analyzed pre- and postoperatively. Injections ondansetron and diclofenac were used as the antiemetic and analgesic medications, respectively, on as-and-when required basis.
Results: Intergroup comparison with respect to pulse rate and systolic and diastolic blood pressures between the two groups was insignificant (p > 0.05). On the first and second postoperative days of LC, average numbers of analgesics used in gabapentin group were 1.2 ± 0.13 and 0.65 ± 0.15 and in placebo group were 2.6 ± 0.10 and 2.2 ± 0.16, respectively. Intergroup comparison was highly significant (p < 0.001). The average number of antiemetics received on first and second postoperative days in gabapentin group was 0.35 ± 0.1 and 0.05 ± 0.04 and in placebo group were 1.31 ± 0.16 and 0.60 ± 0.15, respectively. Intergroup comparison was highly significant (p < 0.001). Pain score in gabapentin group on first and second postoperative days was 2.6 ± 0.17 and 2.2 ± 0.15 and in placebo group 3.80 ± 0.81 and 3.2 ± 0.17, respectively. Intergroup comparison was highly significant (p < 0.001).
Conclusion: Administration of gabapentin 2 h before and 6 h after the surgery significantly decreased the incidence of postoperative pain, nausea, and vomiting.
Key words: Laparoscopic cholecystectomy, gabapentin, postoperative pain, nausea, vomiting
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