DOI: 10.36347/sjams.2015.v03i09.005

Pages: 3157-3163

Successful acute pain management after breast surgery remains challenging, and if not achieved, may increase the likelihood of subsequent chronic pain. Many options are available for the treatment of postoperative pain after breast surgery, including opioids(oral/parenteral), nonopioids (NSAIDS), local anesthetics‘ infiltration or instillation and regional (paravertebral blocks) analgesic techniques. In this study we evaluated the effect of gabapentin as a component of multimodal analgesia comprising local anesthetics instilled through surgical drain, for acute pain and analgesic requirement in patients undergoing modified radical mastectomy. Sixty ASA Class I and II adult patients between 18 to 60 years of age, undergoing elective surgery were included in the study. After randomization to Group C or G, patients were treated as follows: Group C received placebo capsules identical to capsules of gabapentin, every 6 hours, starting the evening before surgery and continued until fourth postoperative day. Patients of Group G received 300mg of gabapentin with the same time points and of the same duration as the control group. In our study we included the patients undergoing breast surgery for breast cancer and failure to adequately treat acute pain well into the postoperative period may lead to the persistence of nociceptive pathways and the development of chronic pain (Post mastectomy pain syndrome). Most of studies have shown that either single preoperative or repeated doses of gabapentin, continued for up to a few days after surgery, decrease acute postoperative pain and/or need for postoperative opioids. . Our results support the use of gabapentin in the acute postoperative period. But further trials are needed to delineate the optimal dose, timing and duration of gabapentin use following surgery.