Pre-emptive Analgesic Effect of Gabapentin in comparison with Diclofenac Sodium in patients undergoing abdominal surgeries
Zahra Ishrat, Zarqa Rani, Iqra Mushtaq, M Taqi
810
ABSTRACT
Background: Pain after abdominal surgery not only
distresses the patient but also results in inadequate respiratory efforts and
cough reflex. So pain relief in these surgeries bears more significance than
mere patient comfort. Acute postoperative pain can lead to significant
morbidity and mortality. Preemptive analgesic given before an operation
provides early analgesia, even before the initial exposure to a noxious
stimulus provides effective postoperative pain relief. In developed countries
pre emptive analgesia is practiced routinely as part of well-defined protocol.
Aim: To compare the efficacy of Gabapentin and Diclofenac
Sodium as pre-emptive analgesic, for post-operative pain relief in patients
undergoing abdominal surgeries.
Methods: This randomized clinical trial was conducted
at Department
of Anesthesia King Edward Medical University/Mayo Hospital Lahore. Total 140 patients were included in the
study and randomly divided into two groups i.e., Gabapentien Group (Group A)
and Diclofenac Sodium Group (Group B), 70
patients in each group. Patients in
Group A were given cap. Gabapentin 600mg and in Group B tab. Diclofenac Sodium
100mg along with a sip of water one hour before shifting to operation theatre .
All patients were anesthetized with standard general anesthesia protocol with same
induction agents. After completion of surgery patients were shifted to recovery
area, where pain was measured at 0 and 30minutes then patients were shifted to
ward and observed there for 12hours. In
ward pain was measured by VAS half hourly for 1st hour and then for
120 (2 hours) 240 (4 hours), 360 (6 hours) and 720(12 hours) minutes after the
surgery.
Results: Mean age of patients in Group-A and in
Group-B was 42.18±12.69 and 41.42±10.41 years. In Group-A there were 34 male
and 36 female patients while in Group-B there were 37 male and 33 female
patients. In this study pain score at 0 and 30th minutes was same in
both treatment groups. However at 60th minute patients in Group-A
had better pain control as compare to Group-B at this point, 77% patients in Group-A and 67%
in Group-B had no pain. (P-value at 60th Min=0.032). At 120th
minute 70% patients in Group-A and 64% in Group-B did not experience any pain.
From 240th minute till 720th minute pain control of
patients was significantly better in Group-A as compared to Group-B. While literature searches showed
none of the study has compared Diclofenac Sodium with Gabapentin as pre-emptive analgesia especially in patients undergoing
abdominal surgeries.
Conclusion: The use of a
single oral dose of Gabapentin is significantly effective as compared to
Diclofenac Sodium when used as Pre-emptive analgesic for post-operative pain
relief. The effect not only lasts longer but it also reduces the need for rescue
analgesia.
Keywords: Gabapentin, Diclofenac Sodium, Pre-emptive
analgesia, Post-operative pain relief
ABSTRACT
Background: Pain after abdominal surgery not only
distresses the patient but also results in inadequate respiratory efforts and
cough reflex. So pain relief in these surgeries bears more significance than
mere patient comfort. Acute postoperative pain can lead to significant
morbidity and mortality. Preemptive analgesic given before an operation
provides early analgesia, even before the initial exposure to a noxious
stimulus provides effective postoperative pain relief. In developed countries
pre emptive analgesia is practiced routinely as part of well-defined protocol.
Aim: To compare the efficacy of Gabapentin and Diclofenac
Sodium as pre-emptive analgesic, for post-operative pain relief in patients
undergoing abdominal surgeries.
Methods: This randomized clinical trial was conducted
at Department
of Anesthesia King Edward Medical University/Mayo Hospital Lahore. Total 140 patients were included in the
study and randomly divided into two groups i.e., Gabapentien Group (Group A)
and Diclofenac Sodium Group (Group B), 70
patients in each group. Patients in
Group A were given cap. Gabapentin 600mg and in Group B tab. Diclofenac Sodium
100mg along with a sip of water one hour before shifting to operation theatre .
All patients were anesthetized with standard general anesthesia protocol with same
induction agents. After completion of surgery patients were shifted to recovery
area, where pain was measured at 0 and 30minutes then patients were shifted to
ward and observed there for 12hours. In
ward pain was measured by VAS half hourly for 1st hour and then for
120 (2 hours) 240 (4 hours), 360 (6 hours) and 720(12 hours) minutes after the
surgery.
Results: Mean age of patients in Group-A and in
Group-B was 42.18±12.69 and 41.42±10.41 years. In Group-A there were 34 male
and 36 female patients while in Group-B there were 37 male and 33 female
patients. In this study pain score at 0 and 30th minutes was same in
both treatment groups. However at 60th minute patients in Group-A
had better pain control as compare to Group-B at this point, 77% patients in Group-A and 67%
in Group-B had no pain. (P-value at 60th Min=0.032). At 120th
minute 70% patients in Group-A and 64% in Group-B did not experience any pain.
From 240th minute till 720th minute pain control of
patients was significantly better in Group-A as compared to Group-B. While literature searches showed
none of the study has compared Diclofenac Sodium with Gabapentin as pre-emptive analgesia especially in patients undergoing
abdominal surgeries.
Conclusion: The use of a
single oral dose of Gabapentin is significantly effective as compared to
Diclofenac Sodium when used as Pre-emptive analgesic for post-operative pain
relief. The effect not only lasts longer but it also reduces the need for rescue
analgesia.
Keywords: Gabapentin, Diclofenac Sodium, Pre-emptive
analgesia, Post-operative pain relief