Gabapentin for Acute Postoperative Pain Control in Total Abdominal Hysterectomy: A randomized controlled trial

Main Article Content

Hathaipat Sukjariangporn
Sittichoke Mahasukontachat


Objectives: To evaluate the effect of gabapentin 300 mg in relieving acute postoperative pain in patients undergoing total abdominal hysterectomy at Chonburi Hospital.
Materials and Methods: A double-blind, randomized, controlled trial was performed on women scheduled for total abdominal hysterectomy at Chonburi Hospital from January 7, 2019 to April 26, 2019. All eligible participants were randomized by computer-generated with block of four into two groups to receive either 300 mg of gabapentin or placebo, orally two hours preoperative. Primary outcome was an additional opioid consumption. Secondary outcomes were time to first additional opioid requirement, pain score, sedative score, opioid-related adverse effects such as nausea/vomiting and pruritus, and gabapentin-related adverse effect as dizziness at 1, 2, 6, 10, 14, 18, 24 hours after surgery.
Results: The results were analyzed from 60 participants (gabapentin N=30, placebo N=30). Mean of total opioid consumption was lower in the gabapentin group compared with the placebo group (14.23 ± 9.78 mg vs 21.77 ± 12.71 mg, p = 0.012), especially during the first 4 hours. Time to first additional opioid requirement was longer in the gabapentin group. The average visual analogue scale and nausea/vomiting scores were lower in the gabapentin group. There was no difference between the means of pruritus and sedative scores. However, dizziness score was found to be higher in the gabapentin group in the first 6 hours.
Conclusion: Premedication with 300 mg of gabapentin orally 2 hours prior to elective total abdominal hysterectomy for patients with both benign and malignant conditions was effective for postoperative pain control with few adverse effects occurred.


Download data is not yet available.

Article Details

Original Article


1. Falcone T, Ridgeway B. Hysterectomy In: Berek JS, Novak E, eds. Berek & Novak’s Gynecology. 16th ed. Philadephia: Lippincott Williams and Wilkins, 2019: 653-77.
2. Nelson G, Bakkum-Gamez J, Kalogera E, Glaser G, Altman A, Meyer LA, et al. Guidelines for perioperative
care in gynecologic/oncology: Enhanced recovery after surgery (ERAS) Society recommendations-2019 update. Int J Gynecol Cancer 2019:ijgc-2019-000356.3.
3. Perioperative pathways: Enhanced Recovery After Surgery. Committee opinion No.750. American College of Obstetricians and Gynecologists. Obstet Gynecol 2018;132:e120-32.
4. Barber EL, Van Le L. Enhanced Recovery Pathways in Gynecology and Gynecologic Oncology. Obstet Gynecol Surv 2015;70:780-92.
5. Ljungqvist O, Scott M, Fearon KC. Enhanced recovery after surgery: A review enhanced recovery after surgery enhanced recovery after surgery. JAMA Surg 2017;152:292-8.6.
6. Gabapentin: FDA Approved labeling. 2011, reference ID 2911805.
7. Modak SD, Magar J, Kakad V. Pre-emptive gabapentin for postoperative pain relief in abdominal hysterectomy. Int J Res Med Sci 2016;4:3755-9.8.
8. Steinberg AC, Schimpf MO, White AB, Mathews C, Ellington DR, Jeppson P, et al. Preemptive analgesia for postoperative hysterectomy pain control: systematic review and clinical practice guidelines. Am J Obstet Gynecol 2017;217:303-313.e306.
9. Farzi F, Naderi Nabi B, Mirmansouri A, Fakoor F, Atrkar Roshan Z, Biazar G, et al. Postoperative pain after abdominal hysterectomy: A randomized, double-blind, controlled trial comparing the effects of rramadol and
gabapentin as premedication. Anesth Pain Med 2016;6:e32360-e.
10. Frouzanfard F, Fazel MR, Abolhasani A, Fakharian E, Mousavi G, Moravveji A. Effects of gabapentin on pain
and opioid consumption after abdominal hysterectomy. Pain Res Manag 2013;18:94-6.
11. Peng PW, Wijeysundera DN, Li CC. Use of gabapentin for perioperative pain control - a meta-analysis. Pain Res Manag 2007;12:85-92.
12. Chang CY, Challa CK, Shah J, Eloy JD. Gabapentin in acute postoperative pain management. Biomed Res Int 2014;2014:631756.
13. Kumar A. Effect of single dose gabapentin on postoperative pain and opioid consumption following total abdominal hysterectomy: A dose fiding study. Surgery Curr Res 2013;3:80.
14. Schmidt PC, Ruchelli G, Mackey SC, Carroll IR. Perioperative gabapentinoids: choice of agent, dose, timing, and effects on chronic postsurgical pain. Anesthesiology 2013;119:1215-21.