DefinePK

Abstract

Background: Postoperative pain following lumbar laminectomy is experienced by almost all patients and may necessitate opioid use. Gabapentin is an anticonvulsant drug shown to be efficient in managing reflex sympathetic dystrophy, neuropathy associated with diabetes, post-herpetic neuralgia, and neuropathic pain. This study aimed to assess the efficacy of pre-emptive administration of gabapentin 300 mg orally for reducing postoperative pain after lumbar laminectomy.
Methodology: A randomized clinical trial was carried out on 50 patients, selected with a convenience sampling method, from July 2023 to October 2024, at Al-Sader Teaching Hospital. All patients were randomly assigned to two groups: a control group received a placebo capsule, and the study group received 300 mg of oral gabapentin 2 hours before skin incision. Postoperative analgesic outcomes were assessed over 24 hours, including total paracetamol consumption and pain intensity measured using the Visual Analogue Scale (VAS). Additionally, hemodynamic parameters were evaluated at baseline (prior to anesthesia) and 15 min after induction.
Result: During the first 24 hours postoperatively, total paracetamol consumption was higher in the control group (640.0 ± 757.18 mg) compared to the gabapentin group (200.0 ± 500.0 mg), (P < 0.05). The number of patients who requested paracetamol was higher in the control group compared to the Group G. The VAS scores during recovery, then at 2, 4, 12, and 24 hr postoperatively, were significantly lower in the Group G compared to the control group (P < 0.05). Mean arterial blood pressure and oxygen saturation were comparable in both groups before induction (baseline) and at 15 min after induction, and the differences were not statistically significant (P > 0.05). Heart rate was significantly different between groups at baseline, but there was no statistically significant difference 15 min after induction.
Conclusion:  Gabapentin 300 mg orally as pre-emptive analgesia decreases postoperative pain and reduces the need for paracetamol consumption after lumbar laminectomy.
Abbreviations: BMI: Basal metabolic index, DOA: duration of anesthesia, DOS: duration of surgery, VAS: Visual Analogue Scale
Keywords: Analgesia; Gabapentin; lumbar laminectomy; pain; VAS score
Citation: Al-Awwady AN. Efficacy of preemptive oral gabapentin for postoperative pain control following lumbar laminectomy. Anaesth. pain intensive care 2025;29(6):463-68. DOI: 10.35975/apic.v29i6.2888