Single dose oral gabapentin as a pre-emptive analgesic for post-operative pain relief in patients undergoing tonsillectomy

Introduction: Post-operative pain and swallowing difficulty following tonsillectomy remain one of the most difficult pain states to manage in Otolaryngology. Many therapeutic modalities - ranging from non-steroidal anti-inflammatory drugs (NSAIDs) to systemic opioids, acetaminophen, and tramadol - have been used for posttonsillectomy pain control in patients. Gabapentin has been recently found to be useful for reducing acute post-operative pain when administered preoperatively. Although various dose regimens have been tried in different surgical settings, the minimum effective dose is not established. The aim of the study: To study the analgesic property of a single of dose oral Gabapentin for postoperative pain relief, to study the hemodynamic variables in patients receiving oral Gabapentin Materials and methods: A total number of, 60 patients were included in the study group between 6 to 16 years. P group (Placebo group) 30 ASA I patients for tonsillectomy receiving oral placebo, G group 30 ASA I patients for tonsillectomy receiving oral gabapentin during a 24-hour post-operative period, the outcomes of interest being postoperative pain intensity; rescue analgesic consumption; or adverse effects such as sedation, nausea and vomiting, dizziness, and headache. Results: The pain score reported by the physician during the first 8 hours, as well as the need for analgesics during 24 hours postoperatively, were significantly decreased in the gabapentinoids group versus the control group. Additionally, there was no significant difference between gabapentinoids and control groups for adverse effect during 24 hours postoperatively. Statistically, significant sedation was observed up to 4 hours in the postoperative period. After 5 hours there was no statistically significant difference in both groups. Conclusion: Oral Gabapentin is effective for postoperative pain relief, reduces the requirement of supplementary analgesics in the postoperative period. Oral Gabapentin has a better hemodynamic profile. Gabapentin is safe for use in pediatric patients.