Gabapentin improves postcesarean delivery pain management: a randomized, placebo-controlled trial

Area of Science:

• Obstetrics and Gynecology
• Anesthesiology
• Pain Management

Background:

• Gabapentin is established for acute and chronic pain but not studied for cesarean delivery.
• Postcesarean delivery pain significantly impacts maternal recovery.
• Multimodal analgesia is standard for cesarean delivery pain management.

Purpose of the Study:

• To evaluate the efficacy of preoperative gabapentin in reducing postcesarean delivery pain.
• To assess maternal satisfaction and opioid consumption with preoperative gabapentin.
• To investigate the safety of gabapentin in mothers and neonates following cesarean delivery.

Main Methods:

• Randomized controlled trial comparing preoperative gabapentin (600 mg) versus placebo.
• Standard multimodal analgesia including spinal anesthesia, ketorolac, acetaminophen, diclofenac, and morphine.
• Pain assessment using visual analog scale (VAS) at 6, 12, 24, and 48 hours post-procedure.
• Evaluation of maternal satisfaction, opioid use, side effects, and neonatal outcomes.
• Assessment of chronic pain at 3 months postpartum.

Main Results:

• Gabapentin group showed significantly lower mean VAS pain scores at 24 hours (21 mm vs. 41 mm, P=0.001).
• Maternal satisfaction was higher in the gabapentin group, with no difference in opioid consumption.
• Increased incidence of severe maternal sedation observed in the gabapentin group (19% vs. 0%).
• No significant differences in neonatal Apgar scores, interventions, or umbilical artery pH.
• Similar incidence of chronic pain at 3 months between groups.

Conclusions:

• Preoperative gabapentin (600 mg) effectively reduces postcesarean delivery pain within a multimodal analgesia regimen.
• Gabapentin enhances maternal satisfaction following cesarean delivery.
• While effective for acute pain, gabapentin's use requires monitoring for potential side effects like sedation.