A SINGLE PREOPERATIVE DOSE OF GABAPENTIN REDUCES POST OPERATIVE TONSILLECTOMY PAIN AND SUBSEQUENT ANALGESIC REQUIREMENT IN CHILDREN

BACKGROUND Gabapentin is an antiepileptic drug used in a variety of chronic pain conditions. Increasing number of randomized trials indicate that gabapentin is effective as a postoperative analgesic. This procedure-specific systematic review aims to investigate whether a single preoperative dose of gabapentin could improve pain relief and reduce subsequent analgesic requirements during the first 24 hrs after tonsillectomy in children. METHODS A Randomized, single blind prospective parallel group placebo controlled study was conducted in 59 patients who underwent tonsillectomy. Thirty patients received single oral dose of gabapentin in the dose of 10-15 mg per kg body weight 60 minutes before surgery. Twenty nine patients received empty capsules .In the post operative unit, pain was assessed every three hours using Wong bakers faces pain scale for 24 hrs after surgery. RESULTS The duration of post operative analgesia in the study group was 17.9 plus or minus 8hrs and the same for control group was 9.1 plus or minus 3.8 hrs. This showed a significant reduction in the postoperative pain in patients who received gabapentin as premedication. In the study group only 4 patients required subsequent analgesics whereas in the control group 18 patients required it (p0.0233).The mean pain score of study group was 1.13 plus or minus 0.35 and the same of control group was 2.50 plus or minus 1.41. This difference is considered to be statistically significant (p0.0409). CONCLUSION A single preoperative oral dose of gabapentin reduced analgesic requirements in the first 24 hrs after tonsillectomy. So the addition of gabapentin prior to tonsillectomy may have an adjunctive role in postoperative pain control.