Friday, September 28, 2012

Gabapentin/Ketamine in post-hysterectomy acute and chronic pain

Dr. Dong


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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