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A comparison of gabapentin and ketamine in acute and chronic pain after hysterectomy.
Anesth Analg. 2009 Nov; 109(5):1645-50.A&A

Abstract

BACKGROUND

Gabapentin and ketamine are popular analgesic adjuvants for improving perioperative pain management. We designed this double-blind, placebo-controlled study to test and compare the preventive effects of perioperative ketamine and gabapentin on early and chronic pain after elective hysterectomy.

METHODS

Sixty patients undergoing abdominal hysterectomy were randomly assigned to 1 of the following 3 groups: control group received oral placebo capsules and bolus plus infusion of saline; ketamine group received oral placebo capsules and, before incision, 0.3 mg/kg IV bolus and 0.05 mgxkg(-1)xh(-1) infusion of ketamine until the end of surgery; and gabapentin group received oral gabapentin 1.2 g and bolus plus infusion of saline. The anesthetic technique was standardized, and the postoperative assessments included verbal rating scales for pain and sedation, IV morphine usage, quality of recovery assessment, recovery of bowel function, resumption of normal activities, and patient satisfaction with their pain management. Patients were questioned at 1, 3, and 6 mo after surgery for chronic postoperative pain.

RESULTS

Postoperative pain scores were significantly lower in the gabapentin group compared with the ketamine and control groups, and patient-controlled analgesia morphine use was significantly reduced in both treatment groups (versus control group) (P < 0.001). Total patient-controlled analgesia morphine use was decreased by 35% and 42% in the ketamine and gabapentin groups, respectively, compared with the control group (P < 0.001). Patient satisfaction with pain treatment was significantly improved in the ketamine and gabapentin groups compared with the control group (P < 0.001). The incidence of incisional pain and related pain scores at the 1-, 3-, and 6-mo follow-up were significantly lower in the gabapentin group compared with the ketamine and control groups (P < 0.001).

CONCLUSION

Gabapentin and ketamine are similar in improving early pain control and in decreasing opioid consumption; however, gabapentin also prevented chronic pain in the first 6 postoperative months.

Authors+Show Affiliations

Department of Anesthesiology and Reanimation, Gülhane Military Medical Academy, Haydarpaçsa Training Hospital, Usküdar, stanbul, Turkey. drhuseyinsen@hotmail.coNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19843803

Citation

Sen, Huseyin, et al. "A Comparison of Gabapentin and Ketamine in Acute and Chronic Pain After Hysterectomy." Anesthesia and Analgesia, vol. 109, no. 5, 2009, pp. 1645-50.
Sen H, Sizlan A, Yanarates O, et al. A comparison of gabapentin and ketamine in acute and chronic pain after hysterectomy. Anesth Analg. 2009;109(5):1645-50.
Sen, H., Sizlan, A., Yanarates, O., Emirkadi, H., Ozkan, S., Dagli, G., & Turan, A. (2009). A comparison of gabapentin and ketamine in acute and chronic pain after hysterectomy. Anesthesia and Analgesia, 109(5), 1645-50. https://doi.org/10.1213/ANE.0b013e3181b65ea0
Sen H, et al. A Comparison of Gabapentin and Ketamine in Acute and Chronic Pain After Hysterectomy. Anesth Analg. 2009;109(5):1645-50. PubMed PMID: 19843803.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A comparison of gabapentin and ketamine in acute and chronic pain after hysterectomy. AU - Sen,Huseyin, AU - Sizlan,Ali, AU - Yanarates,Omer, AU - Emirkadi,Hakan, AU - Ozkan,Sezai, AU - Dagli,Guner, AU - Turan,Alparslan, PY - 2009/10/22/entrez PY - 2009/10/22/pubmed PY - 2009/11/6/medline SP - 1645 EP - 50 JF - Anesthesia and analgesia JO - Anesth Analg VL - 109 IS - 5 N2 - BACKGROUND: Gabapentin and ketamine are popular analgesic adjuvants for improving perioperative pain management. We designed this double-blind, placebo-controlled study to test and compare the preventive effects of perioperative ketamine and gabapentin on early and chronic pain after elective hysterectomy. METHODS: Sixty patients undergoing abdominal hysterectomy were randomly assigned to 1 of the following 3 groups: control group received oral placebo capsules and bolus plus infusion of saline; ketamine group received oral placebo capsules and, before incision, 0.3 mg/kg IV bolus and 0.05 mgxkg(-1)xh(-1) infusion of ketamine until the end of surgery; and gabapentin group received oral gabapentin 1.2 g and bolus plus infusion of saline. The anesthetic technique was standardized, and the postoperative assessments included verbal rating scales for pain and sedation, IV morphine usage, quality of recovery assessment, recovery of bowel function, resumption of normal activities, and patient satisfaction with their pain management. Patients were questioned at 1, 3, and 6 mo after surgery for chronic postoperative pain. RESULTS: Postoperative pain scores were significantly lower in the gabapentin group compared with the ketamine and control groups, and patient-controlled analgesia morphine use was significantly reduced in both treatment groups (versus control group) (P < 0.001). Total patient-controlled analgesia morphine use was decreased by 35% and 42% in the ketamine and gabapentin groups, respectively, compared with the control group (P < 0.001). Patient satisfaction with pain treatment was significantly improved in the ketamine and gabapentin groups compared with the control group (P < 0.001). The incidence of incisional pain and related pain scores at the 1-, 3-, and 6-mo follow-up were significantly lower in the gabapentin group compared with the ketamine and control groups (P < 0.001). CONCLUSION: Gabapentin and ketamine are similar in improving early pain control and in decreasing opioid consumption; however, gabapentin also prevented chronic pain in the first 6 postoperative months. SN - 1526-7598 UR - https://www.unboundmedicine.com/medline/citation/19843803/A_comparison_of_gabapentin_and_ketamine_in_acute_and_chronic_pain_after_hysterectomy_ L2 - https://doi.org/10.1213/ANE.0b013e3181b65ea0 DB - PRIME DP - Unbound Medicine ER -