DR JAMES SANDERS
James Sanders obtained his primary medical degree in the UK before moving to NZ, he is a SET 3 trainee in Dunedin after returning from a year of research at the University of Otago.
PERIOPERATIVE GABAPENTIN IN THE MANAGEMENT OF PAIN FOLLOWING TONSILLECTOMY: A RANDOMISED, DOUBLE-BLIND, PLACEBO-CONTROLLED TRIAL
Dr James G Sanders*
A/Prof Patrick Dawes
Pain is a significant post-tonsillectomy morbidity. Four small placebo-controlled trials of variable quality have shown some benefit in either analgesic consumption and/or pain intensity scores with use of gabapentin for tonsillectomy pain. Our aim is to assess whether gabapentin reduces post-operative pain after tonsillectomy compared to placebo.
In a randomised, double-blind, placebo-controlled study; patients received a single dose of oral gabapentin 600mg or placebo 1-2hrs prior to surgery between January-October 2014. Standard anaesthetic and analgesic protocols were used. The primary outcome was pain assessed by VAS (0-100mm) score; secondary outcomes were analgesic consumption, nausea, vomiting, return to normal diet and activities, and adverse effects. The follow-up period was 14 days. A power analysis suggested 40 participants (20 in each arm) were sufficient to demonstrate a 25% difference in postoperative pain scores between the two groups. Statistical tests are performed at the two-sided 0.05 level of significance.
Results and conclusion:
73 participants were randomised. After withdraws and losses to follow-up, 58 were analysed. 31 in the placebo group and 27 in gabapentin group. Differences in mean resting pain intensity (rVAS) scores were 7.8, 3.9 and 0.9 mm at 2, 4 and 6 hours favouring gabapentin, however this was non-significant (p= 0.309). Interestingly the gabapentin group experienced higher rVAS pain scores after day 5 achieving statistical significance between Day 6 and 10. There was no significant difference between the groups for the other outcomes.
ENT / ORL-HNS Registrar
Department of Otolaryngology- Head and Neck Surgery
Tel: +64 2102572543