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The Efficacy of Gabapentin in Reducing Perioperative Opioid Requirements in Pediatric Cardiac Surgery: A Randomized,
Mohamed A Sayedalahl1, Adel Ali Hassan2, Alaa Eldin A Elmaddawy1
1Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Insights
Gabapentin significantly reduced opioid needs in pediatric cardiac surgery patients. This effective pain management also shortened recovery times and intensive care unit stays.
Area of Science:
- Anesthesiology and Pain Management
- Pediatric Cardiac Surgery
- Pharmacology
Background:
- Perioperative opioid consumption is a significant concern in pediatric cardiac surgery.
- Effective pain management is crucial for optimizing patient recovery and reducing complications.
Purpose of the Study:
- To evaluate the efficacy of gabapentin in decreasing perioperative opioid requirements in pediatric patients undergoing cardiac surgery.
- To assess gabapentin's impact on postoperative pain, recovery metrics, and safety.
Main Methods:
- A prospective, randomized, double-blinded, placebo-controlled trial involving 80 pediatric patients (3-12 years) undergoing cardiac surgery.
- Patients received either gabapentin (10 mg/kg/d) or placebo preoperatively and for 48 hours postoperatively.
- Primary outcome was total postoperative fentanyl consumption; secondary outcomes included pain scores, extubation time, and ICU stay.
Main Results:
- Gabapentin group showed significantly lower total fentanyl consumption (4.04 ± 1.59 µg/kg) compared to placebo (7.01 ± 1.53 µg/kg, p < 0.001).
- Gabapentin administration led to reduced intraoperative opioid use, lower pain scores (MOPS), faster extubation, and shorter ICU stays.
- No significant increase in adverse events was observed in the gabapentin group.
Conclusions:
- Perioperative gabapentin is effective in reducing opioid requirements in pediatric cardiac surgery.
- Gabapentin provides adequate postoperative analgesia and facilitates faster patient recovery.
- Gabapentin represents a valuable adjunct for pain management in this patient population.
Objectives:
To assess the efficacy of gabapentin administration in reducing perioperative opioid consumption among pediatric patients undergoing cardiac surgery with cardiopulmonary bypass.
Design:
A prospective, randomized, double-blinded, placebo-controlled trial.
Setting:
University children's hospital.
Participants:
Eighty patients aged 3 to 12 years undergoing elective corrective cardiac surgery.
Interventions:
Participants were randomly allocated to receive either gabapentin (10 mg/kg/d in 3 divided doses) (group G) or placebo (group P), starting preoperatively and continuing for 48 hours postoperatively.
Measurements And Main Results:
The primary outcome measured was the total rescue fentanyl consumption (in micrograms per kilogram) during the first 48 postoperative hours. Secondary outcomes included intraoperative fentanyl consumption, Modified Objective Pain Score (MOPS), time to extubation, duration of intensive care unit (ICU) stay, and adverse effects. Group G demonstrated a significantly lower requirement for fentanyl (4.04 ± 1.59 µg/kg) compared with group P (7.01 ± 1.53 µg/kg, p < 0.001). Gabapentin also resulted in reduced intraoperative opioid use, lower postoperative pain score, shorter time to extubation, and decreased ICU length of stay, without an increase in adverse events.
Conclusions:
Perioperative gabapentin administration effectively reduces opioid requirements, provides effective postoperative analgesia as assessed by the MOPS, and accelerates recovery in pediatric cardiac surgery.
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