The investigation of the effect of the preoperative gabapentin on postoperative pain in the patients to whom combined spiral epidural anesthesia was implemented under the surgery of lower extremity

ABSTRACTPurpose: Combined Spinal Epidural Anesthesia (CSEA) is frequently implemented in the surgery of lower extremity. It has been reported that preoperative implementations of Gabapentin the activity of which was approved on neurophaeutic and chronicle pains reduce the postoperative pains. In this study, the effects of the preoperative implementations of gabapentin on postoperative pain and adverse effects were investigated on the patients who had combined spinal epidural anesthesia during the surgery of lower extremity.Material and Method: After the consent of the Ethics Committee and the written consent of the cases were taken, cases from ASA I-III aged between 18 and 65 who had surgery of lower extremity were taken into our study. The cases were classified into tow groups randomly. 0.5% levobupivakain (10-15 mg) and fentanile (25 ?g) were given to the group 1 (n=30) (Group P) from the spinal space. In the postoperative period, morphine (3 mg) was given from the epidural space after the spinal block was removed. 600 mg of gabapentin was given to Group 2 1-2 hours before in the preoperative period in addition to the Group 1.In the postoperative period, hemodynamic data (SAB, DAB, KAH), pain score (VAS), sedation score, pruritus score, the need of antihistaminic, the need of extra analgesic and the other adverse effects (sicchasia, hypotension, respiration depression, the change of EKG, bradycardia) were assessed.Results: The demographic features, hemodynamic parameters, the operation periods and sedation scores of the groups were similar. It was found that the postoperative pain scores (VAS) were lower in group G in the 30th, 60th minutes and at 18th and 24th hours (p<0.05). In the postoperative period, sichassia was observed in 10 patients at 18th hour and in 8 patients at 24th hour in Group P whereas sichassia was not observed in any patients in Group G (p<0.001, p<0.005). There was not a statistically meaningful difference between the groups in terms of sichassia scores and the other adverse effects.Conclusion: It was deduced that the preoperative gabapentin statistically reduced the postoperative pain level and pruritus developed due to opioids but did not affect the sicchasia on the patients who had combined spinal epidural anesthesia in the surgery of lower extremity.Key Words: Combined Spinal Epidural Anesthesia, Gabapentin, Opioid, Preemptive analgesia, Postoperative Analgesia.