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Signa vitae : journal for intesive care and emergency medicine, Vol. 2 No. Suppl. 1, 2007.

Review article

Gabapentin for acute and chronic post-surgical pain

Aikaterini Melemeni ; Department of Anaesthesiology, Aretaieio Hospital, School of Medicine, National and Capodistrian University of Athens, 76 Vassilissis Sofias Avenue, 11528 Athens, Greece
Chryssoula Staikou ; Department of Anaesthesiology, Aretaieio Hospital, School of Medicine, National and Capodistrian University of Athens, 76 Vassilissis Sofias Avenue, 11528 Athens, Greece
Argyro Fassoulaki ; Department of Anaesthesiology, Aretaieio Hospital, School of Medicine, National and Capodistrian University of Athens, 76 Vassilissis Sofias Avenue, 11528 Athens, Greece

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Abstract

Pain after surgery remains a significant clinical problem as it impairs recovery adversely and may lead to the transition to chronic pain. Opioid medications are far from ideal agents in suppressing postoperative pain. Gabapentin -an anticonvulsant with antihyperalgesic properties- originally efficacious against neuropathic pain seems to be very promising for the management of pain after surgery as well. Gabapentin, by decreasing noxious stimulus-induced excitatory neurotransmitter release at the spinal cord, may attenuate central sensitization, and eventually decrease postoperative late pain. Furthermore, different sites of action may be pertinent to a synergistic effect with opioids. Both actions (antihyperalgesic effect and synergy with opioid analgesia) may manifest as analgesia and/or opioid-sparing effect after surgery. This has been confirmed by a variety of clinical studies, in a variety of settings. Most of these studies have shown that either single preoperative or repeated doses of gabapentin, continued for up to a few days after surgery, decrease acute postoperative pain and/or need for postoperative opioids. This has been shown for procedures such as abdominal and vaginal hysterectomy, breast surgery for cancer (mastectomy or lumpectomy), lumbar discectomy and spinal fusion, laparoscopic cholecystectomy and other, such as ENT surgery. Finally, a few studies indicate that perioperative gabapentin may as well decrease chronic pain several weeks after surgery.

Keywords

pain postoperative; pain chronic; post-mastectomy pain; anticonvulsants; gabapentin

Hrčak ID:

11974

URI

https://hrcak.srce.hr/11974

Publication date:

1.5.2007.

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