Asbjørn Mohr Drewes

Perioperative gabapentin for the prevention of persistent pain after thoracotomy: A randomized controlled trial

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

  • Kasper Grosen, Danmark
  • Asbjørn Mohr Drewes
  • Anette Højsgaard, Department of Cardiothoracic and Vascular Surgery, Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark., Danmark
  • Mogens Pfeiffer-Jensen, Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark., Danmark
  • Vibeke Elisabeth Hjortdal
  • Hans Kristian Pilegaard

Objectives: To evaluate the effect of perioperative gabapentin treatment for the prevention of persistent post-thoracotomy pain and to establish whether gabapentin has a significant therapeutic impact on acute postoperative pain. Methods: Consecutive patients with pulmonary malignancies scheduled for anterior thoracotomy were enrolled in this randomized, double-blinded, placebo-controlled trial. Patients were given 1200 mg gabapentin or placebo 2 h before surgery followed by increasing doses during 5 postoperative days: 600 mg for day 1; 900 mg for day 2; and 1200 mg for days 3-5. Effective pain relief was provided with perioperative multimodal analgesia with epidural infusion of bupivacaine and morphine for 72 h, and oral acetaminophen, ibuprofen and morphine. The main outcome was persistent post-thoracotomy pain at 6 months. Secondary outcomes included measures of early postoperative post-thoracotomy pain, morphine requirements, recovery and analgesia-related adverse effects over the first 3 weeks as well as persistent post-thoracotomy pain at 3 months. Results: A total of 104 patients were randomly assigned to the intervention or control group; 86 (83%) patients were available for the 14- day analysis, 76 (73%) for the 3-month analysis and 67 (64%) for the 6-month follow-up. At 6 months postoperatively, 47% of patients treated with gabapentin reported persistent post-thoracotomy pain compared with 49% in the placebo group (P = 0.9). No overall clinically or statistically significant differences were observed between groups receiving placebo and gabapentin, respectively, for the secondary outcome measures and treatment-related adverse events. Conclusions: We found no evidence for the superiority of gabapentin over placebo for the treatment of acute pain following thoracotomy or for the prevention of persistent post-thoracotomy pain.

OriginalsprogEngelsk
Artikelnummerezu032
TidsskriftEuropean Journal of Cardio-Thoracic Surgery
Vol/bind46
Nummer1
Sider (fra-til)76-85
Antal sider10
ISSN1010-7940
DOI
StatusUdgivet - 2014

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