The effect of gabapentin versus intrathecal fentanyl on postoperative pain and morphine consumption in cesarean delivery: a prospective, randomized, double-blind study.

PURPOSE: Pain after cesarean delivery is a leading cause of chronic pain and there are many attempts to reduce it without total success. Gabapentin is effective in reducing acute and chronic pain with little experience in parturient. The purpose of this study is to compare the effect of pre-emptive gabapentin with intrathecal fentanyl on reducing postoperative pain and morphine consumption in cesarean surgery.

METHODS

Seventy-eight primiparous women who scheduled for non-emergency cesarean delivery were enrolled in the study and separated into two groups. The control group received 12.5 mg of heavy bupivacaine 0.5 % plus 10 μg of fentanyl intrathecally and the case group received 300 mg of gabapentin orally 2 h before surgery and 12.5 mg of heavy bupivacaine 0.5 % intrathecally. Data collection including blood pressure, heart rate, neonate sedation, Apgar score, visual analogous scale at several hours, at first, need to analgesic postoperatively.

RESULTS

In the fentanyl group, the need for analgesic drug was earlier, total dose of morphine in 24 h and patient satisfaction was higher than the gabapentin group. The mean visual analogous scale at several hours postoperatively in the fentanyl groups was significantly higher than the gabapentin groups (P = 0.001).

CONCLUSION

Preemptive use of gabapentin is a safe and effective way to reduce postoperative pain and morphine consumption in parturients after cesarean surgery.