ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
The effects of the pre-emptive oral gabapentin on post-anesthesia recovery criteria, acute post-thoracotomy pain and development of chronicity in pain with benign thoracotomy operations
Müge Koşucu, Ersagun Tuğcugil, Engin Ertürk, Murat Topbaş, Ahmet Eroğlu, Hülya Ulusoy, Celal Tekinbaş
Department of Anaesthesiology and Reanimation, Medical Faculty of Karadeniz Teknik University, Trabzon, Turkey
DOI : 10.5606/tgkdc.dergisi.2014.7707
Background: In this article, we evaluated the effects of preemptive oral gabapentin on post-anesthesia recovery criteria and acute and chronic post-thoracotomy pain.

Methods: This prospective, randomized, clinical comparison study included 60 ASA II-III class patients undergoing thoracotomy for segmentectomy. The patients were randomly divided into two groups: Group G (n=29) received pre-emptive gabapentin 1200 mg peroral while group C (n=31) received placebo. Anesthetic procedure and post-anesthetic analgesia protocol were standardized. Spontaneous respiration, extubation, swallowing, spontaneous eye opening and verbal cooperation times, sedation, agitation and activity levels and modified Aldrete scores were evaluated. Time to first analgesic requirement, acute post-thoracotomy pain, and postoperative total morphine and additional analgesic consumption were recorded. The chronicity of post-thoracotomy pain was questioned using the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) at the end of one year follow-up.

Results: Shorter verbal cooperation times (p=0.012), less agitation (at 15 min, p=0.001, and 30 min, p=0.001) and earlier recovery times (p<0.0005, at 15 and 30 min), despite greater sedation (at 15 min, p<0.0005, and 30 min, p=0.016) were observed in the gabapentin group. The time to first analgesic requirement was delayed (p<0.005 for all follow-up) and, total morphine and additional analgesic consumptions (p<0.0005 for all follow-ups) were consistent with the numerical rating scale scores. Gabapentin reduced persistent post-thoracotomy pain during the first year (at two, three, six, and 12 months; p=0.040, p=0.031, p=0.001 and p=0.001, respectively).

Conclusion: Pre-emptive oral gabapentin 1200 mg may improve the quality of recovery and reduce acute and chronic postthoracotomy pain.

Keywords : Gabapentin; pain; thoracotomy
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