Bharti, N., Bala, I., Narayan, V., & Singh, G. (2013). Effect of gabapentin pretreatment on propofol consumption, hemodynamic variables, and postoperative pain relief in breast cancer surgery. Acta Anaesthesiologica Taiwanica, 51, 10–13.

DOI Link

Study Purpose

To evaluate the effects of preoperative gabapentin on anesthesia requirements and postoperative pain

Intervention Characteristics/Basic Study Process

Patients were randomized to receive either 600 mg gabapentin or placebo two hours prior to surgery for breast cancer. Patients were followed for 24 hours after surgery. Postoperative analgesia was provided with intramuscular diclofenac sodium 1.5 mg every eight hours and IV morphine 3 mg on demand or when the pain score was 4 or higher.

Sample Characteristics

  • N = 40
  • MEAN AGE = 46.6 years
  • FEMALES: 100%
  • KEY DISEASE CHARACTERISTICS: Breast cancer

Setting

  • SITE: Single site 
  • SETTING TYPE: Inpatient 
  • LOCATION: Taiwan

Phase of Care and Clinical Applications

  • PHASE OF CARE: Active antitumor treatment

Study Design

  • Double-blind, placebo-controlled RCT

Measurement Instruments/Methods

  • Physiologic measures and medication dosages from medical records
  • 11-point numeric pain rating scale

Results

Propofol requirements for induction (p = .02) and maintenance of anesthesia (p = .009) was significantly lower in the gabapentin group. Patients in the gabapentin group had significantly lower pain scores up to two hours postoperatively (p < .001). More patients in the control group required rescue analgesics (p = .03). There were no significant differences between groups in duration of surgery or intraoperative analgesics.

Conclusions

Preoperative gabapentin may reduce anesthesia dose requirements and short-term postoperative pain.

Limitations

  • Small sample (less than 100)
  • Baseline sample/group differences of import
  • The control group had higher American Society of Anesthesiologists scores at baseline, and although not statistically significant, this could have influenced findings. 
  • Patients were only followed for 24 hours.
  • Authors report lower anxiety with gabapentin preoperatively but do not describe the method or timing of this measure.

Nursing Implications

Preoperative gabapentin may reduce anesthesia dose needs and postoperative pain.