Prophylactic use of gabapentin to reduce postoperative nausea and vomiting in patients undergoing diagnostic gynecological laparoscopy

Abstract

Introduction: Postoperative nausea and vomiting (PONV) occurs in patients during the first 24 hours of the surgery. Many drugs have been used for the prevention and treatment of PONV. In this trial, we used gabapentin to evaluate its prophylactic effect in reducing the severity and incidence of PONV in patients undergoing diagnostic laparoscopic gynecological surgery.

Methodology: This, double blind randomized controlled trial, was done in operation theatre complex over a period of six months.140 patients undergoing diagnostic gynecological laparoscopic surgery were selected. Two groups were formed and 70 patients were recruited in each group using lottery method as method of randomization. Group C (control group) was given placebo medication orally two hours before surgery and Group G (gabapentin group) received 600 mg of gabapentin orally two hours before the procedure. Standard general anesthesia technique was used in all patients and incidence and severity of postoperative nausea and vomiting (PONV) was recorded in these patients till 24 hours of laparoscopy.

Results: Severity of PONV was graded from mild to severe. There was no PONV in 25 patients (35.7%) in Group C and 47 patients (67.1 %) in Group G. It was mild in severity in 8 patients (11.4 %) in Group C and 5 patients (7.1 %) in Group G, moderate in 31 patients (44.3 %) in Group C and 15 patients (21.4 %) in Group G and severe PONV was seen in 6 patients (8.6%) in Group C and 3 patients (4.3 %) in Group G (P=0.003). Postoperative nausea and vomiting within 24 hours after procedure was present in 45 patients (64.3%) in Group C and 23 patients (32.9%) in Group G. Results were significant between two groups after statistical analysis with p value of 0.001.

Conclusion: Administration of 600 mg of gabapentin two hours before diagnostic gynecological laparoscopy decreases the frequency and severity of PONV.