Preoperative Use of Gabapentin or Pregabalin on Acute Postoperative Pain Following Laparoscopic Cholecystectomy

Abstract

Introduction: Pain is the earliest most common complain after elective laparoscopic cholecystectomy. Different modalities has been suggested to provide better relief from postoperative pain and to reduce opioid related side effects. Pregabalin or gabapentin on reducing postoperative pain following laparoscopic cholecystectomy has been suggested but comprehensive data regarding the optimal dosage are limited. We designed this study to compare the effectiveness of gabapentin or pregabalin for preemptive analgesia.

Methodology: Seventy two patients undergoing laparoscopic cholecystectomy under general anaesthesia were randomized to receive either gabapentin 600 mg [Group A (n=36) or pregabalin 150 mg [Group B (n=36)] 1 hour before surgery. Intraoperatively hemodynamics were monitored. The duration of analgesia, total doses of rescue analgesics, sedation score and postoperative complications were recorded at 0, 30mins, 1, 2, 6,12 and 24 hours.

Results: Patients in Group B had significantly longer duration of postoperative analgesia as compared to Group A (207.08±54.82min vs 245.97±56.15min p=0.004). Requirement of rescue analgesics for the first 24h was more in Group A (Tramadol 70.83±25mg vs 56.94 ±17.53mg p=0.008). Intra and postoperative haemodynamics, postoperative sedation scores and complications were comparable.

Conclusion: Pregabalin provides longer duration of postoperative analgesia as compared to gabapentin following laparoscopic cholecystectomy.