Preemptive use of gabapentin significantly decreases postoperative pain and rescue analgesic requirements in laparoscopic cholecystectomy

Purpose: To evaluate the comparative preemptive effects of gabapentin and tramadol on postoperative pain and fentanyl requirement in laparoscopic cholecystectomy. Methods: Four hundred fifty-nine ASA I and II patients were randomly assigned to receive 300 mg gabapentin, 100 mg tramadol or placebo in a double-blind manner two hours before laparoscopic cholecystectomy under general anesthesia. Postoperatively, patients' pain scores were recorded on a visual analogue scale every two hours for the initial 12 hr and thereafter every three hours for the next 12 hr. Patients received fentanyl 2 mug.k(-1) intravenously on demand. The total fentanyl consumption for each patient was recorded. Results: Patients in the gabapentin group had significantly lower pain scores at all time intervals (2.65 +/- 3.00, 1.99 +/- 1.48, 1.40 +/- 0.95, 0.65 +/- 0.61) in comparison to tramadol (2.97 +/- 2.35, 2.37 +/- 1.45, 1.89 +/- 1.16, 0.87 +/- 0.50) and placebo (5.53 +/- 2.22, 3.33 +/- 1.37, 2.41 +/- 1.19, 1.19 +/- 0.56). Significantly less fentanyl was consumed in the gabapentin group (221.16 +/- 52.39 mug) than in the tramadol (269.60 +/- 44.17 mug) and placebo groups (355.86 +/- 42.04 mug; P < 0.05). Sedation (33.98%), nausea/retching/vomiting (24.8%) were the commonest side effects in the gabapentin group whereas respiratory depression (3.9%) was the commonest in the tramadol group and vertigo (7.8%) in the placebo group. Conclusion: Preemptive use of gabapentin significantly decreases postoperative pain and rescue analgesic requirement in laparoscopic cholecystectomy.