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Postoperative Pain After Abdominal Hysterectomy: A Randomized, Double-Blind, Controlled Trial Comparing the Effects of Tramadol and Gabapentin as Premedication.

Farzi F, Naderi Nabi B, Mirmansouri A, Fakoor F, Atrkar Roshan Z, Biazar G, Zarei T - Anesth Pain Med (2016)

Bottom Line: This study aims to compare the effects of tramadol and gabapentin, as premedication, in decreasing the pain after hysterectomy.Nausea, vomiting and sedation, in the tramadol group, were higher than in the other two groups, although they were not significant.This study revealed that prescribing gabapentin or tramadol, as premedication, was effective in reducing postoperative pain, without any concerning side-effects.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology, Anesthesiology Research Center, Guilan University of Medical Sciences, Rasht, Iran.

ABSTRACT

Background: Uncontrolled postoperative pain, characteristic to abdominal hysterectomy, results in multiple complications. One of the methods for controlling postoperative pain is preemptive analgesia. Gabapentin and tramadol are both used for this purpose.

Objectives: This study aims to compare the effects of tramadol and gabapentin, as premedication, in decreasing the pain after hysterectomy.

Patients and methods: This clinical trial was performed on 120 eligible elective abdominal hysterectomy patients, divided in three groups of 40, receiving tramadol, gabapentin and placebo, respectively. Two hours before the surgery, the first group was given 300 mg gabapentin, the second one was given 100 mg tramadol, while the other group was given placebo, with 50 ml water. After the surgery, in case of visual analog pain scale (VAS) > 3, up to 3 mg of diclofenac suppository would be used. Pain score, nausea, vomiting, sedation, patient's satisfaction and the number of meperidine administered during 24 hours (1 - 4 - 8 - 12 - 16 - 20 - 24 hours) were recorded. If patients had VAS > 3, despite using diclofenac, intravenous meperidine (0.25 mg/kg) would be prescribed. Data were analyzed using SPSS 21 software, chi-square test, general linear model and repeated measurement.

Results: The three groups were similar regarding age and length of surgery (up to 2 hours). The average VAS, in the placebo group, was higher than in the other two groups (P = 0.0001) and the average received doses of meperidine during 24-hour time were considerably higher in placebo group, compared to the other two groups (55.62 mg in placebo, 18.75 mg in gabapentin and 17.5 mg in tramadol groups, P = 0.0001). Nausea, vomiting and sedation, in the tramadol group, were higher than in the other two groups, although they were not significant. Patients' dissatisfaction, in the placebo group, during initial hours, especially in the fourth hour, was higher (P = 0.0001). In the gabapentin and tramadol groups, the trend of changes in satisfaction score was similar. However, satisfaction in the gabapentin group, during the initial 4 hours was higher, in comparison to the tramadol group (P = 0.0001).

Conclusions: This study revealed that prescribing gabapentin or tramadol, as premedication, was effective in reducing postoperative pain, without any concerning side-effects.

No MeSH data available.


Related in: MedlinePlus

The Trend of Changes of Nausea and Vomiting Score in the Three Groups
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fig26020: The Trend of Changes of Nausea and Vomiting Score in the Three Groups

Mentions: Nausea and vomiting score was lower for the placebo group, compared with the two other groups; however, this difference was not statistically significant (P = 0.29). Nausea and vomiting scores, for the gabapentin and tramadol groups, showed different trends, until 12 hours after the operation, and similar trends afterwards. For the gabapentin group, nausea score was lower in the first hour and increased during the next 12 hours. Contrarily, for the tramadol group, nausea score was higher at first, showing downward trend during the next 8 hours, and increased afterwards until the 12th hour. In both groups, nausea and vomiting scores decreased after the 12th hour, reaching even zero after 20 hours, for the tramadol group (Figure 4).


Postoperative Pain After Abdominal Hysterectomy: A Randomized, Double-Blind, Controlled Trial Comparing the Effects of Tramadol and Gabapentin as Premedication.

Farzi F, Naderi Nabi B, Mirmansouri A, Fakoor F, Atrkar Roshan Z, Biazar G, Zarei T - Anesth Pain Med (2016)

The Trend of Changes of Nausea and Vomiting Score in the Three Groups
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4834422&req=5

fig26020: The Trend of Changes of Nausea and Vomiting Score in the Three Groups
Mentions: Nausea and vomiting score was lower for the placebo group, compared with the two other groups; however, this difference was not statistically significant (P = 0.29). Nausea and vomiting scores, for the gabapentin and tramadol groups, showed different trends, until 12 hours after the operation, and similar trends afterwards. For the gabapentin group, nausea score was lower in the first hour and increased during the next 12 hours. Contrarily, for the tramadol group, nausea score was higher at first, showing downward trend during the next 8 hours, and increased afterwards until the 12th hour. In both groups, nausea and vomiting scores decreased after the 12th hour, reaching even zero after 20 hours, for the tramadol group (Figure 4).

Bottom Line: This study aims to compare the effects of tramadol and gabapentin, as premedication, in decreasing the pain after hysterectomy.Nausea, vomiting and sedation, in the tramadol group, were higher than in the other two groups, although they were not significant.This study revealed that prescribing gabapentin or tramadol, as premedication, was effective in reducing postoperative pain, without any concerning side-effects.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology, Anesthesiology Research Center, Guilan University of Medical Sciences, Rasht, Iran.

ABSTRACT

Background: Uncontrolled postoperative pain, characteristic to abdominal hysterectomy, results in multiple complications. One of the methods for controlling postoperative pain is preemptive analgesia. Gabapentin and tramadol are both used for this purpose.

Objectives: This study aims to compare the effects of tramadol and gabapentin, as premedication, in decreasing the pain after hysterectomy.

Patients and methods: This clinical trial was performed on 120 eligible elective abdominal hysterectomy patients, divided in three groups of 40, receiving tramadol, gabapentin and placebo, respectively. Two hours before the surgery, the first group was given 300 mg gabapentin, the second one was given 100 mg tramadol, while the other group was given placebo, with 50 ml water. After the surgery, in case of visual analog pain scale (VAS) > 3, up to 3 mg of diclofenac suppository would be used. Pain score, nausea, vomiting, sedation, patient's satisfaction and the number of meperidine administered during 24 hours (1 - 4 - 8 - 12 - 16 - 20 - 24 hours) were recorded. If patients had VAS > 3, despite using diclofenac, intravenous meperidine (0.25 mg/kg) would be prescribed. Data were analyzed using SPSS 21 software, chi-square test, general linear model and repeated measurement.

Results: The three groups were similar regarding age and length of surgery (up to 2 hours). The average VAS, in the placebo group, was higher than in the other two groups (P = 0.0001) and the average received doses of meperidine during 24-hour time were considerably higher in placebo group, compared to the other two groups (55.62 mg in placebo, 18.75 mg in gabapentin and 17.5 mg in tramadol groups, P = 0.0001). Nausea, vomiting and sedation, in the tramadol group, were higher than in the other two groups, although they were not significant. Patients' dissatisfaction, in the placebo group, during initial hours, especially in the fourth hour, was higher (P = 0.0001). In the gabapentin and tramadol groups, the trend of changes in satisfaction score was similar. However, satisfaction in the gabapentin group, during the initial 4 hours was higher, in comparison to the tramadol group (P = 0.0001).

Conclusions: This study revealed that prescribing gabapentin or tramadol, as premedication, was effective in reducing postoperative pain, without any concerning side-effects.

No MeSH data available.


Related in: MedlinePlus