Perioperative Gabapentin for Prevention and Attenuation of Postoperative Shoulder Pain After Laparoscopic ovarian cystectomy

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Background: Shoulder pain after laparoscopic procedures is a frequent complication encountered in Gynecology ward. It is provoked by irritation or injury of the phrenic nerve at the diaphragm surface during CO2 pneumoperitoneum. Several treatments have been proposed to reduce post laparoscopic shoulder pain. Gabpantin is one of these treatments which was effective in post laparoscopic pain reduction. The purpose of this study is to evaluate the efficacy of perioperative Gabapentin in preventing and attenuating PLSP after laparoscopic ovarian cystectomy. Material and methods: This is a prospective, randomized, double-blind study. 40 patients undergoing elective laparoscopic ovarian cystectomy in Women hospital Tehran University of medical science were enrolled in our study from April 2008 to march 2009 according to the inclusion and exclusion criteria. The control group received oral placebo capsules and case group 600 mg Gabapentin 0.5 h before surgery. The intensity of post laparoscopic shoulder pain (PLSP) was recorded by patient using a visual analogue scale (VAS) 2, 6, 12 hours post anesthetic recovery. Results: There was no statistical significant difference between 2 groups in clinical characteristics. Duration of laparoscopy was similar in Gabapentin and placebo group. The frequency of post laparoscopic shoulder pain (PLSP) was (45%) in Gabapentin group and (75%) in placebo group (p=0.05) Post laparoscopic shoulder pain (PLSP) intensity in Gabapentin group was significantly lower than placebo group (p=0.004). We did not observe any adverse effect. Conclusion: 600mg Gabapentin as premedication was significantly effective in reducing post laparoscopic shoulder pain intensity after gynecologic laparoscopy compared with placebo without any adverse effect.

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