Xiao-Dan Li1, Chao Han2, Wen-Li Yu3. 1. Department of Anesthesiology, Tianjin First Center Hospital, No.24 Fukang Road, Nankai District, Tianjin City 300192, PR China. 2. Department of Orthopedics, Tianjin Hospital, No. 406 Jiefang South Road, Hexi District, Tianjin City 300211, PR China. 3. Department of Anesthesiology, Tianjin First Center Hospital, No.24 Fukang Road, Nankai District, Tianjin City 300192, PR China. Electronic address: crabwalker@tmu.edu.cn.
Abstract
BACKGROUND: Pain management after open hysterectomy has been investigated for years. Owing to the effect of significant analgesic, gabapentin was often administrated for pre-emptive analgesia. However, the relationship between gabapentin and postoperative pain after open hysterectomy is still controversial. This meta-analysis was applied to assess the efficacy of pre-emptive use of gabapentin in open hysterectomy. METHODS: This meta-analysis of randomized controlled trials (RCTs) was performed to compare the use of gabapentin with placebo in open hysterectomy regarding (1) the mean difference (MD) of postoperative opioid requirements; (2) the changes of visual analogue scale (VAS) scores in two groups; and (3) incidence rate of adverse effects. Systematic searches of all related literatures was conducted using the following databases: MEDLINE, EMBASE, ClinicalTrials.gov and Web of Science. Only randomized controlled trials (RCTs) for open hysterectomy were included. The MD of postoperative opioid requirements and VAS scores, relative risk (RR) of incidence rate of adverse effects in the gabapentin group versus placebo group were extracted throughout the study. RESULTS: Fourteen trials were included in this meta-analysis. The total opioid consumption at 24h was a less in gabapentin group. (MD=-11.61, 95% CI: -16.71 to -6.51, P=0.00) The visual analogue scale (VAS) score at 4, 12 and 24h were less in the gabapentin group. (MD=-16.83, 95% CI: -22.88 to -10.77, P=0.00), (MD=-17.45, 95% CI: -21.83 to -13.08, P=0.00), (MD=-9.83, 95% CI: -13.31 to -6.35, P=0.00) The incidence rate of vomiting and nausea were significantly less in gabapentin groups. (RR 0.13, 95% CI 0.45 to 0.73, P=0.00), (RR 0.67, 95% CI 0.49 to 0.93, P=0.02). Compared with placebo, gabapentin achieved higher patient satisfaction. (MD=20.43, 95% CI: 12.42 to 28.44, P<0.00). CONCLUSION: This meta-analysis suggested that the employment of gabapentin was efficacious in reduction of postoperative opioid consumption, VAS score and some side effects after open hysterectomy.
BACKGROUND:Pain management after open hysterectomy has been investigated for years. Owing to the effect of significant analgesic, gabapentin was often administrated for pre-emptive analgesia. However, the relationship between gabapentin and postoperative pain after open hysterectomy is still controversial. This meta-analysis was applied to assess the efficacy of pre-emptive use of gabapentin in open hysterectomy. METHODS: This meta-analysis of randomized controlled trials (RCTs) was performed to compare the use of gabapentin with placebo in open hysterectomy regarding (1) the mean difference (MD) of postoperative opioid requirements; (2) the changes of visual analogue scale (VAS) scores in two groups; and (3) incidence rate of adverse effects. Systematic searches of all related literatures was conducted using the following databases: MEDLINE, EMBASE, ClinicalTrials.gov and Web of Science. Only randomized controlled trials (RCTs) for open hysterectomy were included. The MD of postoperative opioid requirements and VAS scores, relative risk (RR) of incidence rate of adverse effects in the gabapentin group versus placebo group were extracted throughout the study. RESULTS: Fourteen trials were included in this meta-analysis. The total opioid consumption at 24h was a less in gabapentin group. (MD=-11.61, 95% CI: -16.71 to -6.51, P=0.00) The visual analogue scale (VAS) score at 4, 12 and 24h were less in the gabapentin group. (MD=-16.83, 95% CI: -22.88 to -10.77, P=0.00), (MD=-17.45, 95% CI: -21.83 to -13.08, P=0.00), (MD=-9.83, 95% CI: -13.31 to -6.35, P=0.00) The incidence rate of vomiting and nausea were significantly less in gabapentin groups. (RR 0.13, 95% CI 0.45 to 0.73, P=0.00), (RR 0.67, 95% CI 0.49 to 0.93, P=0.02). Compared with placebo, gabapentin achieved higher patient satisfaction. (MD=20.43, 95% CI: 12.42 to 28.44, P<0.00). CONCLUSION: This meta-analysis suggested that the employment of gabapentin was efficacious in reduction of postoperative opioid consumption, VAS score and some side effects after open hysterectomy.
Authors: Ahmed Abu-Zaid; Osama Alomar; Nora F AlNaim; Fatimah Shakir Abualsaud; Mohammed Ziad Jamjoom; Latifa F AlNaim; Abdullah Ama Almubarki; Saeed Baradwan; Saud Abdullah Saud Aboudi; Faisal Khalid Idris; Meshael Fodaneel; Ismail A Al-Badawi; Hany Salem Journal: Obstet Gynecol Sci Date: 2022-02-23