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Uncontrolled postoperative pain, characteristic to abdominal hysterectomy, results in multiple complications.
Postoperative pain has always been the major reason for
reduced quality of life of patients with abdominal hysterectomy. In this study,
the investigators have discovered the effectiveness of tramadol and gabapentin
as premedication in postoperative pain after abdominal hysterectomy.
Uncontrolled postoperative pain, characteristic to abdominal
hysterectomy, results in multiple complications. One of the methods for
controlling postoperative pain is preemptive analgesia. Gabapentin and tramadol
are both used for this purpose. This study aims to compare the effects of
tramadol and gabapentin, as premedication, in decreasing the pain after
hysterectomy.
This clinical trial was performed on 120 eligible elective
abdominal hysterectomy patients, divided in three groups of 40, receiving
tramadol, gabapentin and placebo, respectively. Two hours before the surgery,
the first group was given 300 mg gabapentin, the second one was given 100 mg
tramadol, while the other group was given placebo, with 50 ml water. After the
surgery, in case of visual analog pain scale (VAS) > 3, up to 3 mg of
diclofenac suppository would be used. Pain score, nausea, vomiting, sedation,
patient's satisfaction and the number of meperidine administered during 24
hours (1 - 4 - 8 - 12 - 16 - 20 - 24 hours) were recorded. If patients had VAS
> 3, despite using diclofenac, intravenous meperidine (0.25 mg/kg) would be
prescribed. Data were analyzed using SPSS 21 software, chi-square test, general
linear model and repeated measurement.
The three groups were similar regarding age and length of
surgery (up to 2 hours). The average VAS, in the placebo group, was higher than
in the other two groups (P = 0.0001) and the average received doses of
meperidine during 24-hour time were considerably higher in placebo group,
compared to the other two groups (55.62 mg in placebo, 18.75 mg in gabapentin
and 17.5 mg in tramadol groups, P = 0.0001). Nausea, vomiting and sedation, in
the tramadol group, were higher than in the other two groups, although they
were not significant. Patients' dissatisfaction, in the placebo group, during
initial hours, especially in the fourth hour, was higher (P = 0.0001). In the
gabapentin and tramadol groups, the trend of changes in satisfaction score was
similar. However, satisfaction in the gabapentin group, during the initial 4
hours was higher, in comparison to the tramadol group (P = 0.0001).
This study revealed that prescribing gabapentin or tramadol,
as premedication, was effective in reducing postoperative pain, without any
concerning side-effects.
Anesthesiology and Pain Medicine
Postoperative Pain After Abdominal Hysterectomy: A Randomized, Double-Blind, Controlled Trial Comparing the Effects of Tramadol and Gabapentin as Premedication
Farnoush Farzi et al.
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