Background: Gabapentin is a novel drug used for the treatment of postoperative pain.
Oral morphine has gained acceptance as the treatment of choice for patients with chronic
cancer pain but also can be used to treat acute postoperative pain. Objectives: The aim of this
study was to compare the efficacy of pre-operative oral Gabapentin with oral morphine on
post-operative pain relief and total analgesic consumption after major abdominal cancer
surgeries. Study design: A randomized double blind study. Sitting: Academic medical center.
Methods: 60 ASA I-III patients (age ≥18 years) who were scheduled for Elective major
abdominal cacer surgery. Patients were randomly Divided into one of two groups. Group I
(gabapentin group): patients Received gabapentin capsules 900mg 1 hr. pre-operatively.
Group II (morphine group): patients received morphine sulphate 30mg tab 1 hr. Preoperatively.
At the end of the operation patients were monitored for vital signs after 30 min, 1h, 2h, 4h,
6h, 12h, 24h hours. The severity of pain was assessed using visual Analog scale after 30min,
1h, 2h, 4h, 6h, 12h, 24h hours post-operative. The time of the first analgesic request and total
morphine consumption in 24 hours were recorded. The level of sedation, incidence of side
effects were recorded and treated.
Results: The post-operative heart rate was reduced significantly in group I compared to group
II in the first half an hour of the postoperative period (P < 0.01),and there was statistically
significant difference between studied groups as regards post-operative MAP in the first hour
(P< 0.01) The mean postoperative VAS score was significantly reduced in group I compared
to group II in the first two hours post-operative period group I compared to group II in the
first two hours post-operative period (P < 0.01). There was significant prolongation in the
first request of analgesia in the group I (7.65± 4.970) compared to that of group II
(5.34±3.66). There was reduction in the total amount of postoperative morphine consumption in group I (7.43±4.39) in comparison to group II (13.47±4.73) with (p < 0.044). there was
significant reduction in number of patients developed nausea and vomiting in group I.
Sedation score was higher in group I compared to group II. Limitations: This study is limited
by its small sample size. Conclusion: pre-operative use of oral gabapentin 900mg
significantly reduced postoperative pain and decreased the need for opioids with less side
effect than 30 mg sustained release oral morphine.