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Does Preemptive Gabapentin Reduce Morphine Consumption and Remaining Leg Pain After Lumbar Discectomy?: A Randomized Double-blind, Placebo-controlled Clinical Trial

Vahedi, Payman MD*; Shimia, Mohammad MD*; Aghamohammadi, Dawood MD; Mohajernezhadfard, Zahra MD; Shoeibi, Ali MD§; Lotfinia, Iraj MD*; Vahedi, Afsaneh MD; Vahedi, Yazdan MD; Jamali, Payman MD, MPH; Salehpour, Firooz MD*; Farajirad, Mohammad MD**; Bustani, Mohammadreza MD*; Haghir, Amirhossein MD*

doi: 10.1097/WNQ.0b013e3182059576
Original Articles
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Aim Residual leg pain makes the outcome in lumbar discectomy unfavorable. The aim of this study was to compare gabapentin with placebo in terms of reduced remaining postoperative leg pain and morphine consumption after single level lumbar laminectomy and discectomy.

Methods We conducted a randomized parallel group, double-blind, placebo-controlled clinical trial. Two hundred and six patients were randomly assigned into 2 groups. Each group received preanesthesia identical capsules containing gabapentin or placebo. Similar anesthesia protocol was performed. One hundred thirty patients were excluded secondarily and a total of 76 patients with residual, but less degree postoperative leg pain remained in the study. Postoperative visual analog scale and morphine consumption via patient-controlled analgesia pumps were recorded and statistically compared at 6-hour intervals for 24 hours.

Results No statistical significance was found between the 2 groups in terms of reduced postoperative leg pain or morphine consumption (P >0/0.05). No clinical evidence to prove synergism between gabapentin and morphine in discectomy patients was found.

Conclusions The results of this clinical trial failed to show that preemptive gabapentin is more effective than placebo with regard to leg pain reduction and morphine consumption during the acute stage after single level lumbar laminectomey and discectomy. However the possibility remains that multiple dose regimens of gabapentin would be beneficial.

*Spine Research Center, Department of Neurosurgery

Department of Anesthesia and Critical Care, Tabriz University of Medical Sciences, Tabriz

Student Research Committee, Tehran University of Medical Sciences, Tehran

§Departments of Neurology

**Neurosurgery

Public Health, Mashad University of Medical Sciences, Mashad

Department of Public Health, Shahrood University of Medical Science

Department of Public Health, Shahrrod Welfare and Rehabilitation Center, Shahrood, Iran

This study has been conducted as a medical dissertation for the specialty degree (No.87/3-8/11) by the first author, the research protocol was approved by the research Vice Chancellor of Tabriz University of Medical Sciences and the ethics committee of Tabriz University of Medical Sciences (registered number: 883). The trial has been registered at www.clinicaltrials.gov (registered number: NCD01014520). Informed consent was taken from all participants.

Reprints: Payman Vahedi, MD, Department of Neurosurgery, Imam Hospital, Tabriz University of Medical Sciences, Tabriz, Iran (e-mail: payman.vahedi@gmail.com).

© 2011 Lippincott Williams & Wilkins, Inc.