Key result
Premedication with 300 mg oral gabapentin or 1000 mg intravenous paracetamol significantly reduced post-operative pain compared to placebo, with similar efficacy between the active treatments.
Why the study?
Does oral gabapentin or intravenous paracetamol reduce post-operative pain in patients undergoing elective tibial fracture surgery?
RCT (n=96)
randomised
Does oral gabapentin or intravenous paracetamol reduce post-operative pain in patients undergoing elective tibial fracture surgery?
Premedication with either oral gabapentin or intravenous paracetamol effectively reduces post-operative pain after tibial fracture surgery compared to placebo.
Answers are grounded in this paper and cite their sources.
Supports gabapentin or paracetamol premedication for post-operative pain after tibial fracture surgery; extends RCT evidence to elective orthopedic procedures.
Introduction: Much attention has been devoted to the management of post-operative pain. Pain reduction brings more comfort and leads to faster recovery and mobilisation of a patient. In addition, it reduces thromboembolic events and eventually the length of hospital stay and cost of treatment. This study was conducted to compare the efficacy of gabapentin versus paracetamol for post-operative analgesia after tibial fracture surgery. Materials and Methods: This study was designed as a randomised, controlled clinical trial, in which 96 patients undergoing elective tibial fracture surgery under general anaesthesia were divided into three groups (gabapentin, paracetamol and placebo). Half an hour before induction of anaesthesia, patients received 300 mg oral gabapentin or 1000 mg paracetamol or 100 ml normal saline (these two latter as intravenous infusions) according to their groups. Surgery was performed under general anaesthesia, with similar anaesthetic regimen for all patients. The pain intensity was measured using a visual analogue scale ruler at 2, 4 and 6 h after operation. Collected data were recorded then and analysed using the statistical software SPSS. Results: At 2, 4 and 6 h after surgery, no significant differences were observed between the two paracetamol and gabapentin groups in terms of pain intensity. Pain intensity in the placebo group was significantly higher than the two case groups. Mean opioid consumption as a rescue intervention was not significantly different between the three groups. However, the placebo group included a larger number of patients requiring opioid analgesics, which was significantly different. Conclusion: A significant pain reduction was observed in both case groups as compared to placebo. Gabapentin and paracetamol had similar efficacies in post-operative analgesia after tibial fracture surgery. No difference was found between the three groups in terms of mean opioid analgesic requirements.
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Modir et al. (2017) conducted an RCT in tibial fracture (n=96). gabapentin versus paracetamol vs. placebo was evaluated on pain intensity at 2, 4 and 6 h after operation. Premedication with 300 mg oral gabapentin or 1000 mg intravenous paracetamol significantly reduced post-operative pain compared to placebo, with similar efficacy between the active treatments.
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