Preoperative Gabapentin for Minimally Invasive Hysterectomy: A Randomized Controlled Trial

Abstract

Study objective: To evaluate whether a single dose of gabapentin given preoperatively reduces narcotic use 24 hours after minimally invasive hysterectomy (MIH).

Design: Randomized controlled trial.

Setting: Single academic-affiliated community hospital.

Patients: Women undergoing MIH for benign indications between June 2016 and June 2017.

Interventions: Subjects were randomized to receive a preoperative regimen of acetaminophen, celecoxib, and gabapentin versus acetaminophen and celecoxib alone.

Measurements and main results: The primary outcome assessed was the total amount of narcotics used at 24 hours after surgery. Secondary outcomes included adverse effects from gabapentin use, total narcotics used, and pain scores at 2 weeks after surgery. A total of 129 women were randomized and eligible for analysis in the gabapentin study arm (n = 68) or the control arm (n = 61). Demographic characteristics and surgical details were similar between groups. Narcotics used at 24 hours after surgery totaling 168 versus 161 oral morphine milligram equivalents in the gabapentin and control groups, respectively, did not significantly differ between groups (p = .60). Total narcotics used and pain scores at 2 weeks after surgery and the rates of adverse effects from gabapentin were also similar between study arms.

Conclusion: Single-dose, preoperative gabapentin for women undergoing benign MIH does not reduce total opioid use 24 hours after surgery.

Trial registration: ClinicalTrials.gov NCT02703259.

Keywords: Enhanced recovery after surgery; Narcotics; Opioid use; Perioperative pain.