Background
Considering that an adequate postoperative analgesia is crucial for patients’ well-being and early recuperation, the aim of this study is to assess the efficacy and safety of preoperative gabapentin in the management of acute postoperative pain during first 24h after laparoscopic sleeve gastrectomy.
Material and Method
42 patients (ASA I-II) scheduled for laparoscopic sleeve gastrectomy were recruited to participate in a randomized double-blind, placebo-controlled study. These subjects were randomized into two groups: group G (n=22) and group P (n=20) both receiving an oral dose of 400 mg gabapentin, respectivelly a matching placebo capsule, administered 1h prior to the surgical procedure.
PCA with intravenous morphine was used as strategy for acute postoperative pain treatment in both groups.
The primary outcomes were postoperative pain severity (VAS) at rest, evaluated at 1h, 6h, 12h and 24h, time to first analgesic bolus requirement and cumulative morphine consumption during first 24h postoperatively. The incidence of sedation, dizziness, nausea/vomiting and urine retention were recorded as secondary outcomes. Mann Whitney U-test and t-test were used to evaluate the results, p<0.05 being considered statistically significant.
Results and discussion
VAS scores analysis revealed significantly decreased values for group G compared to group P, during first 24h postoperatively (p<0.05). Although group G showed a delayed analgesic request compared to group P, this difference is devoid of statistical significance. Total morphine consumption in group G was statistically lower by comparison to group P (p<0.05).
The rate of nausea/vomiting, as well as the incidence of urine retention were significantly lower in group G compared to group P(p<0.05). On the other hand, there was no statistical difference between groups regarding the number of patients experiencing sedation and dizziness.
Conclusions
Preoperative single oral dose of 400 mg gabapentin is effective in improving acute postoperative pain management during first 24h after laparoscopic sleeve gastrectomy, with a substantial decrease in morphine requirement and the subsequent reduction in some morphine-associated adverse effects.


09 / The beneficial effect of preoperative gabapentin on acute postoperative pain after laparoscopic sleeve gastrectomy