Keywords:

Gabapentin, preemptive, head and neck cancer surgery, total opioid consumption, postoperative pain

Gabapentin, introduced as an anticonvulsant, has been found to be effective in treating neuropathic and acute postoperative pain. However, its use in alleviating post-operative pain after Head and Neck cancer surgery has not been evaluated in clinical practice.

Fifty-four patients scheduled to undergo Head and Neck surgery for malignancy were recruited into 2 groups of 27 each(group G-receiving 600mg Gabapentin and group P receiving a placebo 2 hrs before surgery). The anaesthetic protocol was identical for both groups. Patient controlled analgesia with morphine was used and pain scores using Visual Analogue Scale (VAS 0-10) at 1,2,3,4,46,12,18 and 24 hr were measured. Total opioid consumption in first 24 hours postoperative was also measured. Incidence of side-effects like sedation, and nausea and vomiting was also assessed.

27 patients in group G and 26 patients in group P completed the study. The total morphine consumption in 24 hrs was significantly less in group G (P<0.01) when compared to group P. The pain scores were also significantly lower in gabapentin group at 1 h, 6h, 12h and 24h (P<0.01). The baseline heart rate, systolic and diastolic and blood pressure was also significantly lower in the experimental group. Analysis of the results from our study concludes that preemptive gabapentin 600mg when given 2 hrs before head and neck malignancy surgery was an effective intervention to reduce postoperative pain. Total morphine consumption in first 24 hrs postoperative was also reduced significantly.