The effect of preemptive gabapentin for early recovery criteria, acute pain after thoracotomy and chronicity of pain at surgery of thoracotomy

Gabapentin has been used effectively as a premedication drug to the treatment of acute postoperative pain a variety of surgical procedures. We evaluated the effect of the preemptive oral gabapentin on post anesthesia recovery criteria, acute post-thoracotomy pain and development of chronicty in pain with thoracotomy operations / the incidence of chronic post-thoracotomy pain.Fourthy patients undergoing thoracotomy operation were randomly allocated two groups to receive gabapentin 1200 mg p.o. (n:20) or placebo capsules (n:20) 1 h prior the surgery. Anaesthetic procedure and postanaesthetic analgesia protocol were standardized. All patients received morphine via a patient-controlled device. We evaluated spontaneous respiration, extubation, swallow, spontaneous eye opening and verbal cooperation times, sedation, ajitation and activity levels, modified-aldrete scores, time for the first analgesic requirement and acut post-thoracotomy pain with NRS (Numerical Rating Scale). At the end of 48 h, total morfin and additional analgesic consumption, side effects and postoperative quality of sleeping have been evaluated. Participants were questioned about the chronicity of post-thoracotomy pain using LANSS (Leeds Assessment of Neuropathic Symptoms and Signs) at the end of six-month follow-up.Intraoperative all hemodynamic values did not differ between the groups. There was no significant difference between groups in terms of spontaneous respiration, extubation, swallow, spontaneous eye opening, while verbal cooperation times showed a shortening in gabapentin group. Postoperative sedation score at 15 minutes were higher but agitation score were lower at 15 minutes and 30 minutes in gabapentin group. No differences observed in terms of Modified-Aldrete Score at 1 hour and activity levels. The time to first analgesic requirement was earlier in control group, and NRS values were lower in gabapentin group in all time points. Total morphine and additional analgesic consumption was found to be lower in gabapentin group. There were no differences in side effects and quality of sleeping. We couldn?t find any statisticaly differences in LANSS values at months 1, 3, and 6. lower incidence of chronic post-thoracotomy pain has been determined in gabapentin group for first six month, although this was not statistically significant.Oral gabapentin 1200 mg as a premedication drug with thoracotomy operations may improve the quality of recovery from anaesthesia, decreased acute post-thoracotomy pain, morfin and additional aanalgesic consumption. Further studies would be needed to assess its effect on chronicity post-toracotomy pain.