A Comparison of
Gabapentin and Ketamine in Acute and Chronic Pain following Hysterectomy
Sen, Sizlan et al. Anesthesia and analgesia.
2009 nov. 109(5). 1645-1650
One of
the main objectives and roles of an anesthesiologist is to investigate
individual agents or combinations of agents that can alter the perception of
post operative pain and allow ones return to baseline functioning. This
specific study analyzes two drugs with differing analgesic mechanisms and how
they can individually alter post operative opioid use, improve results on
subjective pain scores and decrease chronic incisional pain levels. Sixty
patients whom were scheduled for abdominal hysterectomy were randomly assigned
to either a control group, a ketamine group (received 0.3mg/kg IV bolus
followed by 0.05mg/kg IV continuous infusion) and a gabapentin group (received
1.2g PO). Following random assignment, standard anesthetic practice was
utilized and patients were assessed immediately post op for acute measures and
at 1, 3 and 6 months for chronic changes. The study utilized various modes of
statistical analysis and concluded that immediate post operative pain scores
were reduced in the gabapentin group, amount of pca morphine use was higher in
the control group vs the ketamine and gabapentin groups and chronic surgical
site incisional pain was decreased in the gabapentin group. Based on the
findings of this study it demonstrates the power of multimodal pain strategies
by utilizing agents of various mechanisms and the importance of exploring
different methods of improving patient care.
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