To Evaluate The Preoperative Gabapentin?s Effect on The Postoperative Pain in The Patients Performed Supraclavicular Brachial Plexus Blockade in The Upper Extremity Surgery

Aim: We have aimed to evaluate the preoperative gabapentin?s effect on the postoperative pain in the patients on which supraclavicular brachial plexus blockade for upper extremity surgery was implemented.Material and Method: After obtaining University ethical approval and the patients? written approval, supraclavicular brachial plexus blockade was implemented to 60 patients containing urological patients who would have arterio-venous fistula operation, plastic and reconstructive surgery patients who would have debridemant and flapping operation and orthopedical patients who would have upper extremity surgery.The patients were divided into two groups randomly; in the Group I, 40 ml 0.5% levobupivacaine and 0.5 ?g.kg-1 fentanyl was used, in the Group II, 800 mg gabapentin was used orally 30-45 minutes before the blockade. Blockade was performed in the guidance of the supraclavicular technique and the peripheric nevre stimulator. After the implementation had begun, surgery start time, the sedation and analgesia levels were assessed and recorded through Visual Analog Scale. Hemodynamic parameters were measured and recorded at the 5th, 10th, 15th, 30th, 45th, 60th, 90th and 120th minutes before and after the blockade. Whether the emesis, vomiting, itching, respiratory depression and Horner Syndrome occurred or not was observed during anesthesia practice and in the post anesthesia care unit. 4 mg ondansetron was implemented to the patients who had emesis and vomiting. The starting time of the pain was recorded during the postoperative second day control visit or talking to the patients on the phone. The patients were recommended to use tramadolol HCl orally when the pain begins.Findings: It was found out that demographic data of the groups were similar to each other and there were no statistically significant difference between them. While the starting time of the surgery was 25.67±3.77 in group I and 20.50±2.48 in group II, a statistically significant difference was found (p<0.05). No statistically significant difference was found between the groups according to the Visual Analog Scale and sedation scale values in the preoperative and the postoperative period (p>0.05). Postoperative pain starting time was 14.60±1.14 in Group I and 20.43±2.36 in Group II, and the statistically significant difference was found (p<0.05). No other adverse effects were observed on the patients.Result: We have reached the idea of orally applied 800 mg gabapentine in the preoperative period made the surgery starting time shorter and postoperative analgesia duration longer in brachial plexus blockade performed during upper extremity surgery without hemodynamic changes and other adverse effects.Key words: Levobupivacaine, postoperative analgesia, supraclavicular brachial plexus blockade, fentanyl, gabapentine, preemptive analgesia