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A combination of gabapentin and local anaesthetics attenuates acute and late pain after abdominal hysterectomy

Published online by Cambridge University Press:  01 June 2007

A. Fassoulaki ,
A. Melemeni ,
E. Stamatakis ,
G. Petropoulos  and
C. Sarantopoulos
A. Fassoulaki*
Affiliation:
University of Athens, Medical School, Aretaieio Hospital, Department of Anaesthesiology, Athens, Greece
A. Melemeni
Affiliation:
University of Athens, Medical School, Aretaieio Hospital, Department of Anaesthesiology, Athens, Greece
E. Stamatakis
Affiliation:
University of Athens, Medical School, Aretaieio Hospital, Department of Anaesthesiology, Athens, Greece
G. Petropoulos
Affiliation:
University of Athens, Medical School, Aretaieio Hospital, Department of Anaesthesiology, Athens, Greece
C. Sarantopoulos
Affiliation:
Medical College of Wisconsin, Department of Anaesthesiology, Milwaukee, WI, USA
*
Correspondence to: Arygyro Fassoulaki, Department of Anaesthesiology, Aretaieio University Hospital, Medical School, 76 Vassilissis Sofias Ave, 11528 Athens, Greece. E-mails: afassou1@otenet.gr, fassoula@aretaieio.uoa.gr; Tel: +30210 7286334, +30210 7286323; Tel/Fax: +30210 9024530
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Summary

Background and objective

Gabapentin and local anaesthetics may decrease postoperative pain and analgesic needs. The aim of the study was to investigate the effect of the combination of these drugs on the analgesic needs as well as on acute and late pain after abdominal hysterectomy.

Methods

Sixty patients undergoing abdominal hysterectomy were randomly assigned to receive postoperatively oral gabapentin 400 mg 6 hourly for 7 days plus continuous wound infusion of ropivacaine 0.75% for 30 h or placebo capsules identical to those of gabapentin for 7 days and continuous wound infusion of normal saline for 30 h. Morphine consumption (PCA) for 48 h, paracetamol 500 mg plus codeine 30 mg (Lonalgal® tablets) intake on days 3–7, visual analogue pain scores at rest and after cough during the first 7 postoperative days, the need for analgesics at home and the presence and incidence of pain after 1 month were recorded.

Results

The treatment group consumed less cumulative morphine over the first 48 h (31 ± 13.2 mg vs. 50 ± 20.5 mg in controls, P < 0.001) and less Lonalgal® tablets on days 3–7 (z = 2.54, P = 0.011). The visual analogue score values at rest and after cough did not differ between the groups during the first 7 postoperative days. One month postoperatively, fewer patients in the treatment group experienced pain due to surgery than in the control group (17/27 vs. 21/24, P = 0.045).

Conclusion

Gabapentin and continuous wound infusion with ropivacaine 0.75% decreased analgesic needs and late pain in patients undergoing abdominal hysterectomy.

Keywords

PHARMACOLOGY, gabapentin, ropivacaine, morphine, paracetamol, codeineSURGICAL PROCEDURES, abdominal hysterectomyPAIN, postoperative
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 24 , Issue 6 , June 2007 , pp. 521 - 528
Copyright
Copyright © European Society of Anaesthesiology 2006

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