A placebo-controlled randomized clinical trial of perioperative administration of gabapentin, rofecoxib and their combination for spontaneous and movement-evoked pain after abdominal hysterectomy.

摘要: Current treatments for post-injury movement-evoked pain are inadequate. Non-opioids may complement opioids, which preferentially reduce spontaneous pain, but most have incomplete efficacy as single agents. This trial evaluates of a gabapentin-rofecoxib combination following hysterectomy. In addition to IV-PCA morphine, 110 patients received either placebo, gabapentin (1800 mg/day), rofecoxib (50 mg/day) or (1800/50 starting 1 h pre-operatively 72 h. Outcomes included at rest, evoked by sitting, peak expiration and cough, morphine consumption expiratory flow (PEF). For gabapentin, combination, 24 (100 mm VAS) was: rest-23.6 (P<0.05 vs. all treatments), 13.8, 14.4 12.1; during cough-50.7 41.5, 44.8 30.8; 48 (mg) 130.4 81.7, 75.6 57.2 rofecoxib) PEF (% baseline) 63.9 77.2, 76.7 87.5 rofecoxib). Adverse effects were similar in groups except sedation was more frequent with gabapentin. Combination reduced interference movement, mood sleep (P<0.05) superior these three (P<0.05). These data suggest that is agent postoperative pain. Other benefits include opioid sparing, increased suggesting accelerated pulmonary recovery. Future research should identify optimal dose-ratios this other analgesic combinations.