The Effects of Gabapentin on Post-Operative Pain and Anxiety, Morphine Consumption and Patient Satisfaction in Paediatric Patients Following the Ravitch Procedure—A Randomised, Double-Blind, Placebo-Controlled, Phase 4 Trial

The aim of the study was to investigate whether the use of pre- and postoperative gabapentin can decrease postoperative pain, morphine consumption, anxiety and side effects, as well as improve patient satisfaction. A total of 56 patients, 9–17 years of age, undergoing a modified Ravitch procedure, w...

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Main Authors: Dariusz Fenikowski, Lucyna Tomaszek, Henryk Mazurek, Danuta Gawron, Piotr Maciejewski
Format: Article
Language:English
Published: MDPI AG 2022-08-01
Series:Journal of Clinical Medicine
Subjects:
Online Access:https://www.mdpi.com/2077-0383/11/16/4695
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author Dariusz Fenikowski
Lucyna Tomaszek
Henryk Mazurek
Danuta Gawron
Piotr Maciejewski
author_facet Dariusz Fenikowski
Lucyna Tomaszek
Henryk Mazurek
Danuta Gawron
Piotr Maciejewski
author_sort Dariusz Fenikowski
collection DOAJ
description The aim of the study was to investigate whether the use of pre- and postoperative gabapentin can decrease postoperative pain, morphine consumption, anxiety and side effects, as well as improve patient satisfaction. A total of 56 patients, 9–17 years of age, undergoing a modified Ravitch procedure, were randomised (allocation ratio 1:1) to receive multiple perioperative doses of gabapentin (preoperatively 15 mg/kg, postoperatively 7.5 mg/kg, two times per day for three days) or a placebo. All the patients received intravenous infusion of morphine, paracetamol and non-steroidal anti-inflammatory drugs. Metamizole was given as a “rescue drug”. The observation period included the day of surgery and three postoperative days. The primary outcomes were postoperative pain intensity (at rest, during deep breathing and coughing). Additional outcomes included the consumption of morphine, the total number of doses of metamizole, anxiety, postoperative side effects and patient satisfaction. Median average and maximal pain scores (on the day of surgery and on the second postoperative day) were significantly lower only in the gabapentin group at rest (<i>p</i> < 0.05). Compared to the placebo group, gabapentin treatment reduced the demand for morphine on the first postoperative day (median 0.016 vs. 0.019 mg/kg/h; <i>p</i> = 0.03) and the total number of metamizole doses (median 1 vs. 2 <i>p</i> = 0.04). Patient satisfaction was significantly greater in the gabapentin group (median 10 vs. 9; <i>p</i> = 0.018). Anxiety and postoperative side effects were similar in both groups (<i>p</i> > 0.05). Pre- and postoperative gabapentin administration as part of a multimodal analgesic regimen may decrease postoperative pain, opioid consumption and demand for a “rescue drug”, as well as improve patient satisfaction.
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spelling doaj.art-c741898256ca48b29ca2db865acd319d2023-12-03T13:52:11ZengMDPI AGJournal of Clinical Medicine2077-03832022-08-011116469510.3390/jcm11164695The Effects of Gabapentin on Post-Operative Pain and Anxiety, Morphine Consumption and Patient Satisfaction in Paediatric Patients Following the Ravitch Procedure—A Randomised, Double-Blind, Placebo-Controlled, Phase 4 TrialDariusz Fenikowski0Lucyna Tomaszek1Henryk Mazurek2Danuta Gawron3Piotr Maciejewski4Department of Thoracic Surgery, Institute of Tuberculosis and Lung Diseases, Rabka-Zdrój Branch, 34-700 Rabka-Zdrój, PolandDepartment of Thoracic Surgery, Institute of Tuberculosis and Lung Diseases, Rabka-Zdrój Branch, 34-700 Rabka-Zdrój, PolandDepartment of Pneumonology and Cystic Fibrosis, Institute of Tuberculosis and Lung Diseases, Rabka-Zdrój Branch, 34-700 Rabka-Zdrój, PolandDepartment of Thoracic Surgery, Institute of Tuberculosis and Lung Diseases, Rabka-Zdrój Branch, 34-700 Rabka-Zdrój, PolandDepartment of Thoracic Surgery, Institute of Tuberculosis and Lung Diseases, Rabka-Zdrój Branch, 34-700 Rabka-Zdrój, PolandThe aim of the study was to investigate whether the use of pre- and postoperative gabapentin can decrease postoperative pain, morphine consumption, anxiety and side effects, as well as improve patient satisfaction. A total of 56 patients, 9–17 years of age, undergoing a modified Ravitch procedure, were randomised (allocation ratio 1:1) to receive multiple perioperative doses of gabapentin (preoperatively 15 mg/kg, postoperatively 7.5 mg/kg, two times per day for three days) or a placebo. All the patients received intravenous infusion of morphine, paracetamol and non-steroidal anti-inflammatory drugs. Metamizole was given as a “rescue drug”. The observation period included the day of surgery and three postoperative days. The primary outcomes were postoperative pain intensity (at rest, during deep breathing and coughing). Additional outcomes included the consumption of morphine, the total number of doses of metamizole, anxiety, postoperative side effects and patient satisfaction. Median average and maximal pain scores (on the day of surgery and on the second postoperative day) were significantly lower only in the gabapentin group at rest (<i>p</i> < 0.05). Compared to the placebo group, gabapentin treatment reduced the demand for morphine on the first postoperative day (median 0.016 vs. 0.019 mg/kg/h; <i>p</i> = 0.03) and the total number of metamizole doses (median 1 vs. 2 <i>p</i> = 0.04). Patient satisfaction was significantly greater in the gabapentin group (median 10 vs. 9; <i>p</i> = 0.018). Anxiety and postoperative side effects were similar in both groups (<i>p</i> > 0.05). Pre- and postoperative gabapentin administration as part of a multimodal analgesic regimen may decrease postoperative pain, opioid consumption and demand for a “rescue drug”, as well as improve patient satisfaction.https://www.mdpi.com/2077-0383/11/16/4695Ravitch proceduregabapentinmorphinepostoperative painpain assessment methodanxiety
spellingShingle Dariusz Fenikowski
Lucyna Tomaszek
Henryk Mazurek
Danuta Gawron
Piotr Maciejewski
The Effects of Gabapentin on Post-Operative Pain and Anxiety, Morphine Consumption and Patient Satisfaction in Paediatric Patients Following the Ravitch Procedure—A Randomised, Double-Blind, Placebo-Controlled, Phase 4 Trial
Journal of Clinical Medicine
Ravitch procedure
gabapentin
morphine
postoperative pain
pain assessment method
anxiety
title The Effects of Gabapentin on Post-Operative Pain and Anxiety, Morphine Consumption and Patient Satisfaction in Paediatric Patients Following the Ravitch Procedure—A Randomised, Double-Blind, Placebo-Controlled, Phase 4 Trial
title_full The Effects of Gabapentin on Post-Operative Pain and Anxiety, Morphine Consumption and Patient Satisfaction in Paediatric Patients Following the Ravitch Procedure—A Randomised, Double-Blind, Placebo-Controlled, Phase 4 Trial
title_fullStr The Effects of Gabapentin on Post-Operative Pain and Anxiety, Morphine Consumption and Patient Satisfaction in Paediatric Patients Following the Ravitch Procedure—A Randomised, Double-Blind, Placebo-Controlled, Phase 4 Trial
title_full_unstemmed The Effects of Gabapentin on Post-Operative Pain and Anxiety, Morphine Consumption and Patient Satisfaction in Paediatric Patients Following the Ravitch Procedure—A Randomised, Double-Blind, Placebo-Controlled, Phase 4 Trial
title_short The Effects of Gabapentin on Post-Operative Pain and Anxiety, Morphine Consumption and Patient Satisfaction in Paediatric Patients Following the Ravitch Procedure—A Randomised, Double-Blind, Placebo-Controlled, Phase 4 Trial
title_sort effects of gabapentin on post operative pain and anxiety morphine consumption and patient satisfaction in paediatric patients following the ravitch procedure a randomised double blind placebo controlled phase 4 trial
topic Ravitch procedure
gabapentin
morphine
postoperative pain
pain assessment method
anxiety
url https://www.mdpi.com/2077-0383/11/16/4695
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