Premedication with gabapentin, Alprazolam or a placebo for abdominal hysterectomy

Effect on preoperative anxiety, Postoperative pain and morphine consumption

Tim Thomas Joseph, Handattu Mahabaleswara Krishna, Shyamsunder Kamath

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background and Aims: Utility of gabapentin for preoperative anxiolysis as compared to commonly administered alprazolam is not evident. The aim of the present study was to compare the effects of preoperative oral gabapentin 600 mg, alprazolam 0.5 mg or a placebo on preoperative anxiety along with postoperative pain and morphine consumption. Methods: Seventy five patients scheduled for abdominal hysterectomy under general anaesthesia were included. Groups gabapentin, alprazolam and placebo, received oral gabapentin 600 mg, alprazolam 0.5 mg and one capsule of oral Bcomplex forte with Vitamin C respectively, on the night prior to surgery and 2 h prior to surgery. Visual analogue scale (VAS) was used to measure the anxiety and postoperative pain. All patients received patientcontrolled analgesia. Statistical tests used were Kruskal–Wallis test, Wilcoxon signed rank test and oneway ANOVA. Results: Alprazolam provided significant anxiolysis (median [interquartile range] baseline VAS score 35 [15.5, 52] to 20 [6.5, 34.5] after drug administration; P = 0.007). Gabapentin did not provide significant decrease in anxiety (median [interquartile range] VAS score 21 [7.5, 41] to 20 [6.5, 34.5]; P = 0.782). First analgesic request time (median [interquartile range in minutes]) was longer in group gabapentin (17.5 [10, 41.25]) compared to group placebo (10 [5, 15]) (P = 0.019) but comparable to that in group alprazolam (15 [10, 30]). Cumulative morphine consumption at different time periods and total morphine consumption (mean [standard deviation]) at the end of study period (38.65 [18.04], 39.91 [15.73], 44.29 [16.02] mg in group gabapentin, alprazolam and placebo respectively) were comparable. Conclusion: Gabapentin 600 mg does not have significant anxiolytic effect compared to alprazolam 0.5 mg. Alprazolam 0.5 mg was found to be an effective anxiolytic in the preoperative period. Neither alprazolam nor gabapentin, when compared to placebo showed any opioid sparing effects postoperatively.

Original languageEnglish
Pages (from-to)693-699
Number of pages7
JournalIndian Journal of Anaesthesia
Volume58
Issue number6
DOIs
Publication statusPublished - 01-11-2014

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Alprazolam
Premedication
Postoperative Pain
Hysterectomy
Morphine
Anxiety
Placebos
Visual Analog Scale
Anti-Anxiety Agents
gabapentin
Preoperative Period
Nonparametric Statistics
Analgesia
General Anesthesia
Opioid Analgesics
Ascorbic Acid
Capsules
Analgesics
Analysis of Variance

All Science Journal Classification (ASJC) codes

  • Anesthesiology and Pain Medicine

Cite this

@article{a4119a6f29104cb5998ae73ff155d7cf,
title = "Premedication with gabapentin, Alprazolam or a placebo for abdominal hysterectomy: Effect on preoperative anxiety, Postoperative pain and morphine consumption",
abstract = "Background and Aims: Utility of gabapentin for preoperative anxiolysis as compared to commonly administered alprazolam is not evident. The aim of the present study was to compare the effects of preoperative oral gabapentin 600 mg, alprazolam 0.5 mg or a placebo on preoperative anxiety along with postoperative pain and morphine consumption. Methods: Seventy five patients scheduled for abdominal hysterectomy under general anaesthesia were included. Groups gabapentin, alprazolam and placebo, received oral gabapentin 600 mg, alprazolam 0.5 mg and one capsule of oral Bcomplex forte with Vitamin C respectively, on the night prior to surgery and 2 h prior to surgery. Visual analogue scale (VAS) was used to measure the anxiety and postoperative pain. All patients received patientcontrolled analgesia. Statistical tests used were Kruskal–Wallis test, Wilcoxon signed rank test and oneway ANOVA. Results: Alprazolam provided significant anxiolysis (median [interquartile range] baseline VAS score 35 [15.5, 52] to 20 [6.5, 34.5] after drug administration; P = 0.007). Gabapentin did not provide significant decrease in anxiety (median [interquartile range] VAS score 21 [7.5, 41] to 20 [6.5, 34.5]; P = 0.782). First analgesic request time (median [interquartile range in minutes]) was longer in group gabapentin (17.5 [10, 41.25]) compared to group placebo (10 [5, 15]) (P = 0.019) but comparable to that in group alprazolam (15 [10, 30]). Cumulative morphine consumption at different time periods and total morphine consumption (mean [standard deviation]) at the end of study period (38.65 [18.04], 39.91 [15.73], 44.29 [16.02] mg in group gabapentin, alprazolam and placebo respectively) were comparable. Conclusion: Gabapentin 600 mg does not have significant anxiolytic effect compared to alprazolam 0.5 mg. Alprazolam 0.5 mg was found to be an effective anxiolytic in the preoperative period. Neither alprazolam nor gabapentin, when compared to placebo showed any opioid sparing effects postoperatively.",
author = "Joseph, {Tim Thomas} and Krishna, {Handattu Mahabaleswara} and Shyamsunder Kamath",
year = "2014",
month = "11",
day = "1",
doi = "10.4103/0019-5049.147134",
language = "English",
volume = "58",
pages = "693--699",
journal = "Indian Journal of Anaesthesia",
issn = "0019-5049",
publisher = "Medknow Publications and Media Pvt. Ltd",
number = "6",

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TY - JOUR

T1 - Premedication with gabapentin, Alprazolam or a placebo for abdominal hysterectomy

T2 - Effect on preoperative anxiety, Postoperative pain and morphine consumption

AU - Joseph, Tim Thomas

AU - Krishna, Handattu Mahabaleswara

AU - Kamath, Shyamsunder

PY - 2014/11/1

Y1 - 2014/11/1

N2 - Background and Aims: Utility of gabapentin for preoperative anxiolysis as compared to commonly administered alprazolam is not evident. The aim of the present study was to compare the effects of preoperative oral gabapentin 600 mg, alprazolam 0.5 mg or a placebo on preoperative anxiety along with postoperative pain and morphine consumption. Methods: Seventy five patients scheduled for abdominal hysterectomy under general anaesthesia were included. Groups gabapentin, alprazolam and placebo, received oral gabapentin 600 mg, alprazolam 0.5 mg and one capsule of oral Bcomplex forte with Vitamin C respectively, on the night prior to surgery and 2 h prior to surgery. Visual analogue scale (VAS) was used to measure the anxiety and postoperative pain. All patients received patientcontrolled analgesia. Statistical tests used were Kruskal–Wallis test, Wilcoxon signed rank test and oneway ANOVA. Results: Alprazolam provided significant anxiolysis (median [interquartile range] baseline VAS score 35 [15.5, 52] to 20 [6.5, 34.5] after drug administration; P = 0.007). Gabapentin did not provide significant decrease in anxiety (median [interquartile range] VAS score 21 [7.5, 41] to 20 [6.5, 34.5]; P = 0.782). First analgesic request time (median [interquartile range in minutes]) was longer in group gabapentin (17.5 [10, 41.25]) compared to group placebo (10 [5, 15]) (P = 0.019) but comparable to that in group alprazolam (15 [10, 30]). Cumulative morphine consumption at different time periods and total morphine consumption (mean [standard deviation]) at the end of study period (38.65 [18.04], 39.91 [15.73], 44.29 [16.02] mg in group gabapentin, alprazolam and placebo respectively) were comparable. Conclusion: Gabapentin 600 mg does not have significant anxiolytic effect compared to alprazolam 0.5 mg. Alprazolam 0.5 mg was found to be an effective anxiolytic in the preoperative period. Neither alprazolam nor gabapentin, when compared to placebo showed any opioid sparing effects postoperatively.

AB - Background and Aims: Utility of gabapentin for preoperative anxiolysis as compared to commonly administered alprazolam is not evident. The aim of the present study was to compare the effects of preoperative oral gabapentin 600 mg, alprazolam 0.5 mg or a placebo on preoperative anxiety along with postoperative pain and morphine consumption. Methods: Seventy five patients scheduled for abdominal hysterectomy under general anaesthesia were included. Groups gabapentin, alprazolam and placebo, received oral gabapentin 600 mg, alprazolam 0.5 mg and one capsule of oral Bcomplex forte with Vitamin C respectively, on the night prior to surgery and 2 h prior to surgery. Visual analogue scale (VAS) was used to measure the anxiety and postoperative pain. All patients received patientcontrolled analgesia. Statistical tests used were Kruskal–Wallis test, Wilcoxon signed rank test and oneway ANOVA. Results: Alprazolam provided significant anxiolysis (median [interquartile range] baseline VAS score 35 [15.5, 52] to 20 [6.5, 34.5] after drug administration; P = 0.007). Gabapentin did not provide significant decrease in anxiety (median [interquartile range] VAS score 21 [7.5, 41] to 20 [6.5, 34.5]; P = 0.782). First analgesic request time (median [interquartile range in minutes]) was longer in group gabapentin (17.5 [10, 41.25]) compared to group placebo (10 [5, 15]) (P = 0.019) but comparable to that in group alprazolam (15 [10, 30]). Cumulative morphine consumption at different time periods and total morphine consumption (mean [standard deviation]) at the end of study period (38.65 [18.04], 39.91 [15.73], 44.29 [16.02] mg in group gabapentin, alprazolam and placebo respectively) were comparable. Conclusion: Gabapentin 600 mg does not have significant anxiolytic effect compared to alprazolam 0.5 mg. Alprazolam 0.5 mg was found to be an effective anxiolytic in the preoperative period. Neither alprazolam nor gabapentin, when compared to placebo showed any opioid sparing effects postoperatively.

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