Oral gabapentin for postoperative pain relief after lower limb surgery-a randomized controlled trail

In addition to anticonvulsant property of gabapentin, it was demonstrated that gabapentin also possesses analgesic property. In this randomized control trial the efficacy of gabapentin for postoperative pain relief was studied on 60 adult patients of either sex, belonging to ASA grade I or II, in the age range of 18–60 years posted for lower limb surgeries under spinal analgesia.

The patients were randomly divided into two groups of 30 patients each. Group A patients (n=30) received oral gabapentin 1200 mg 2 hours prior to scheduled surgery and the same dose was given at 9:00 am on the first and second postoperative days. Group B (n=30) served as control group received only placebo capsules. Subarachnoid block was established in both the groups by administering 4 ml of hyperbaric bupivacaine. Vital parameters such as heart rate, blood pressure respiratory rate along with pain assessment (VAS) were recorded at regular intervals in the postoperative period. Rescue analgesia was provided with intramuscular butorphanol.

It was observed that patients in group A exhibited excellent quality of postoperative pain relief as compared to group B (P<0.0001). The requirement of opioids in the form of butorphanol was greatly reduced in group A as compared to group B (P<0.0001). Patient satisfaction using verbal rating scale was higher in Group A as compared to group B (P<0.0001). Minor side effects encountered were mild sedation, shivering, nausea, vomiting and dizziness which showed no significant difference between the groups.

Oral administration of gabapentin holds great promise for excellent postoperative pain relief and reduction in the overall requirement of opioids without producing significant side effects.