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Gabapentin Dosages for Postoperative Analgesia Following Open Thoracotomy

Randomized Prospective Study Comparing Variable Gabapentin Dosages for Postoperative Analgesia Following Open Thoracotomy

Status
Terminated
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT05172570
Enrollment
20
Registered
2021-12-29
Start date
2021-04-06
Completion date
2022-03-02
Last updated
2024-03-21

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Pain, Postoperative, Thoracotomy

Keywords

acute pain, neuropathic pain

Brief summary

Gabapentin is a nerve medication that treats pain. The specific aim of the study is to compare the difference in the postoperative use of no gabapentin, 300 mg gabapentin 3x daily, or 300 mg gabapentin once at night. Our hypothesis is that higher doses of gabapentin will correlate with decreased pain at the incision and chest tube sites and decreased opioid consumption.

Detailed description

The purpose of this study is to determine the effectiveness of various dosages of gabapentin, as part of an ERAS protocol, for postoperative analgesic control after open thoracotomy and additionally determine if there is a correlation of the dosage of gabapentin with pulmonary complication and impaired cognition postoperatively. Given the widespread use of gabapentin and the huge variability in dosing, our study aims to simplify ERAS protocols for thoracotomy by figuring out the optimal dosing of gabapentin and whether its use overall decreases postoperative opioid consumption and complications. The specific aim of the study is to compare the difference in the postoperative use of no gabapentin, 300 mg gabapentin 3x daily, or 300 mg gabapentin once at night.

Interventions

DRUGGabapentin

Gabapentin is a common medication used preoperatively and postoperatively as part of multimodal analgesia to help with acute pain.

Sponsors

Indiana University
Lead SponsorOTHER

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
No

Inclusion criteria

* Pt undergoing open thoracotomy at Indiana University Hospital * ASA 1,2,3 or 4 * Age 18 or older, male or female

Exclusion criteria

* History of substance abuse in the past 6 months which would include heroin, marijuana or any other illegal street drugs * Patient on home dose of gabapentin or pregabalin * Patient staying intubated after surgery * Patient above 70yo * Patient (home dose) taking more than 30mg PO morphine equivalent (PME) per day * Known allergy or other contraindications to the study medications, which include gabapentin * Patient unable to receive post-op epidural * BMI above 40 * Creatinine clearance less than 30

Design outcomes

Primary

MeasureTime frameDescription
The Primary Endpoint of This Study Will be Incision and Chest Tube Site Pain Scores.1 hour after surgeryThe pain scores will be collected at incision and chest tube. It will be measured by the study team investigator using a Visual Analog Scale (VAS) using a scale of documentation 0-10 for 10 being the worst pain and 0 being no pain.

Secondary

MeasureTime frameDescription
Incidence of FallsAs they occur up to 96 hours after surgery.Participants with one or more falls
Opioid Usage1 hour after surgery.opioid usage will be collected from electronically medical record as documented by nursing staff administering the medications.
Time to First Opioid RequestAs it first occurs, up to 96 hours after surgerythe timeframe between end of surgery to first opioid request
Sedation Scores1hour after surgery.Sedation is measured as minimum to maximum awareness; high value worse to less awareness (awake/alert, quietly awake, asleep but arousable, deep sleep)
Pulmonary ComplicationsAs they occur up to 96 hours after surgery.any incidence of increase oxygen requirements or respiratory depression will be recorded
Delirium24 hours after surgery.Number of Participants reported they experienced delirium.
Visual Disturbance24 hours after surgery.incidence of any visual disturbance reported by the participants will be reported.
Dizziness24 hours after surgery.incidence of any dizziness reported by the participant reported.
Hospital Length of StayFrom the date of surgery to date of hospital discharge (up to 24 days)timeframe from start of surgery to time of discharge (up to 24 days)

Countries

United States

Participant flow

Recruitment details

Study terminated early-only enrolled 20 subjects

Participants by arm

ArmCount
No Gabapentin
Patients will not receive any gabapentin
6
300 mg Gabapentin 3X Per Day
Patients will receive 300mg gabapen...
7
300 mg Gabapentin Once Per Day at Night
Patients will receive 300mg gabapentin once a day at night after open thoracotomy Gabapentin: Gabapentin is a common medication used preoperatively and postoperatively as part of multimodal analgesia to help with acute pain.
7
Total20

Withdrawals & dropouts

PeriodReasonFG000FG001FG002
Overall StudyPI Decision due to equipment shortages001
Overall Studywithdrawn-unable to take postop required study meds due to being NPO010

Baseline characteristics

CharacteristicNo Gabapentin300 mg Gabapentin 3X Per Day300 mg Gabapentin Once Per Day at NightTotal
Age, Categorical
<=18 years
0 Participants0 Participants0 Participants0 Participants
Age, Categorical
>=65 years
3 Participants5 Participants0 Participants8 Participants
Age, Categorical
Between 18 and 65 years
3 Participants2 Participants7 Participants12 Participants
Age, Continuous64.5 Years64.2 Years51.2 Years60 Years
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants0 Participants0 Participants0 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
6 Participants7 Participants7 Participants20 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants0 Participants
Overall Number of Baseline Participants6 participants7 participants7 participants20 participants
Sex: Female, Male
Female
4 Participants4 Participants4 Participants12 Participants
Sex: Female, Male
Male
2 Participants3 Participants3 Participants8 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
deaths
Total, all-cause mortality
0 / 60 / 60 / 6
other
Total, other adverse events
0 / 60 / 60 / 6
serious
Total, serious adverse events
0 / 60 / 60 / 6

Outcome results

Primary

The Primary Endpoint of This Study Will be Incision and Chest Tube Site Pain Scores.

The pain scores will be collected at incision and chest tube. It will be measured by the study team investigator using a Visual Analog Scale (VAS) using a scale of documentation 0-10 for 10 being the worst pain and 0 being no pain.

Time frame: 24 hour after surgery

Population: 24-hour pain scores

ArmMeasureGroupValue (MEAN)
No GabapentinThe Primary Endpoint of This Study Will be Incision and Chest Tube Site Pain Scores.24-hour incision pain2.8 score on a scale
No GabapentinThe Primary Endpoint of This Study Will be Incision and Chest Tube Site Pain Scores.24-hour chest tube pain4.3 score on a scale
300 mg Gabapentin 3X Per DayThe Primary Endpoint of This Study Will be Incision and Chest Tube Site Pain Scores.24-hour incision pain3.5 score on a scale
300 mg Gabapentin 3X Per DayThe Primary Endpoint of This Study Will be Incision and Chest Tube Site Pain Scores.24-hour chest tube pain4.3 score on a scale
300 mg Gabapentin Once Per Day at NightThe Primary Endpoint of This Study Will be Incision and Chest Tube Site Pain Scores.24-hour incision pain4.8 score on a scale
300 mg Gabapentin Once Per Day at NightThe Primary Endpoint of This Study Will be Incision and Chest Tube Site Pain Scores.24-hour chest tube pain6.7 score on a scale
Primary

The Primary Endpoint of This Study Will be Incision and Chest Tube Site Pain Scores.

The pain scores will be collected at incision and chest tube. It will be measured by the study team investigator using a Visual Analog Scale (VAS) using a scale of documentation 0-10 for 10 being the worst pain and 0 being no pain.

Time frame: 1 hour after surgery

Population: 1-hour Pain Scores

ArmMeasureGroupValue (MEAN)
No GabapentinThe Primary Endpoint of This Study Will be Incision and Chest Tube Site Pain Scores.1-hour incision pain3.5 score on a scale
No GabapentinThe Primary Endpoint of This Study Will be Incision and Chest Tube Site Pain Scores.1-hour chest tube pain4.8 score on a scale
300 mg Gabapentin 3X Per DayThe Primary Endpoint of This Study Will be Incision and Chest Tube Site Pain Scores.1-hour incision pain0 score on a scale
300 mg Gabapentin 3X Per DayThe Primary Endpoint of This Study Will be Incision and Chest Tube Site Pain Scores.1-hour chest tube pain0 score on a scale
300 mg Gabapentin Once Per Day at NightThe Primary Endpoint of This Study Will be Incision and Chest Tube Site Pain Scores.1-hour incision pain6.7 score on a scale
300 mg Gabapentin Once Per Day at NightThe Primary Endpoint of This Study Will be Incision and Chest Tube Site Pain Scores.1-hour chest tube pain7.9 score on a scale
Primary

The Primary Endpoint of This Study Will be Incision and Chest Tube Site Pain Scores.

The pain scores will be collected at incision and chest tube. It will be measured by the study team investigator using a Visual Analog Scale (VAS) using a scale of documentation 0-10 for 10 being the worst pain and 0 being no pain.

Time frame: 96 hour after surgery

Population: 96-hour pain scores

ArmMeasureGroupValue (MEAN)
No GabapentinThe Primary Endpoint of This Study Will be Incision and Chest Tube Site Pain Scores.96-hour incision pain scores3.8 score on a scale
No GabapentinThe Primary Endpoint of This Study Will be Incision and Chest Tube Site Pain Scores.96-hour chest tube scores6 score on a scale
300 mg Gabapentin 3X Per DayThe Primary Endpoint of This Study Will be Incision and Chest Tube Site Pain Scores.96-hour incision pain scores2.5 score on a scale
300 mg Gabapentin 3X Per DayThe Primary Endpoint of This Study Will be Incision and Chest Tube Site Pain Scores.96-hour chest tube scores2.5 score on a scale
300 mg Gabapentin Once Per Day at NightThe Primary Endpoint of This Study Will be Incision and Chest Tube Site Pain Scores.96-hour incision pain scores3 score on a scale
300 mg Gabapentin Once Per Day at NightThe Primary Endpoint of This Study Will be Incision and Chest Tube Site Pain Scores.96-hour chest tube scores5 score on a scale
Primary

The Primary Endpoint of This Study Will be Incision and Chest Tube Site Pain Scores.

The pain scores will be collected at incision and chest tube. It will be measured by the study team investigator using a Visual Analog Scale (VAS) using a scale of documentation 0-10 for 10 being the worst pain and 0 being no pain.

Time frame: 72 hour after surgery

Population: 72-hour pain scores

ArmMeasureGroupValue (MEAN)
No GabapentinThe Primary Endpoint of This Study Will be Incision and Chest Tube Site Pain Scores.72-hour incision pain4 score on a scale
No GabapentinThe Primary Endpoint of This Study Will be Incision and Chest Tube Site Pain Scores.72-hour chest tube pain5 score on a scale
300 mg Gabapentin 3X Per DayThe Primary Endpoint of This Study Will be Incision and Chest Tube Site Pain Scores.72-hour incision pain2 score on a scale
300 mg Gabapentin 3X Per DayThe Primary Endpoint of This Study Will be Incision and Chest Tube Site Pain Scores.72-hour chest tube pain2.7 score on a scale
300 mg Gabapentin Once Per Day at NightThe Primary Endpoint of This Study Will be Incision and Chest Tube Site Pain Scores.72-hour incision pain3.5 score on a scale
300 mg Gabapentin Once Per Day at NightThe Primary Endpoint of This Study Will be Incision and Chest Tube Site Pain Scores.72-hour chest tube pain5 score on a scale
Primary

The Primary Endpoint of This Study Will be Incision and Chest Tube Site Pain Scores.

The pain scores will be collected at incision and chest tube. It will be measured by the study team investigator using a Visual Analog Scale (VAS) using a scale of documentation 0-10 for 10 being the worst pain and 0 being no pain.

Time frame: 48 hour after surgery

Population: 48-hour pain scores

ArmMeasureGroupValue (MEAN)
No GabapentinThe Primary Endpoint of This Study Will be Incision and Chest Tube Site Pain Scores.48-hour incision pain4.2 score on a scale
No GabapentinThe Primary Endpoint of This Study Will be Incision and Chest Tube Site Pain Scores.48-hour chest tube pain5.7 score on a scale
300 mg Gabapentin 3X Per DayThe Primary Endpoint of This Study Will be Incision and Chest Tube Site Pain Scores.48-hour incision pain1.8 score on a scale
300 mg Gabapentin 3X Per DayThe Primary Endpoint of This Study Will be Incision and Chest Tube Site Pain Scores.48-hour chest tube pain3.0 score on a scale
300 mg Gabapentin Once Per Day at NightThe Primary Endpoint of This Study Will be Incision and Chest Tube Site Pain Scores.48-hour incision pain3.8 score on a scale
300 mg Gabapentin Once Per Day at NightThe Primary Endpoint of This Study Will be Incision and Chest Tube Site Pain Scores.48-hour chest tube pain5.7 score on a scale
Secondary

Delirium

Number of Participants reported they experienced delirium.

Time frame: 72 hours after surgery.

Population: 72-hour delirium

ArmMeasureValue (NUMBER)
No GabapentinDelirium0 participants
300 mg Gabapentin 3X Per DayDelirium0 participants
300 mg Gabapentin Once Per Day at NightDelirium0 participants
Secondary

Delirium

incidence of delirium will be recorded

Time frame: 48 hours after surgery.

Population: 48-hour delirium

ArmMeasureValue (NUMBER)
No GabapentinDelirium0 participants
300 mg Gabapentin 3X Per DayDelirium0 participants
300 mg Gabapentin Once Per Day at NightDelirium0 participants
Secondary

Delirium

Number of Participants reported they experienced delirium.

Time frame: 96 hours after surgery.

Population: 96-hour delirium

ArmMeasureValue (NUMBER)
No GabapentinDelirium0 participants
300 mg Gabapentin 3X Per DayDelirium0 participants
300 mg Gabapentin Once Per Day at NightDelirium0 participants
Secondary

Delirium

Number of Participants reported they experienced delirium.

Time frame: 24 hours after surgery.

Population: 24-hour delirium

ArmMeasureValue (NUMBER)
No GabapentinDelirium0 participants
300 mg Gabapentin 3X Per DayDelirium0 participants
300 mg Gabapentin Once Per Day at NightDelirium0 participants
Secondary

Dizziness

incidence of any dizziness reported by the participant reported.

Time frame: 96 hours after surgery.

Population: 96-hour dizziness

ArmMeasureValue (NUMBER)
No GabapentinDizziness0 participants
300 mg Gabapentin 3X Per DayDizziness0 participants
300 mg Gabapentin Once Per Day at NightDizziness0 participants
Secondary

Dizziness

incidence of any dizziness reported by the participant reported.

Time frame: 72 hours after surgery.

Population: 72-hour dizziness

ArmMeasureValue (NUMBER)
No GabapentinDizziness0 participants
300 mg Gabapentin 3X Per DayDizziness0 participants
300 mg Gabapentin Once Per Day at NightDizziness0 participants
Secondary

Dizziness

iincidence of any dizziness reported by the participant reported.

Time frame: 48 hours after surgery.

Population: 48-hour dizziness

ArmMeasureValue (NUMBER)
No GabapentinDizziness0 participants
300 mg Gabapentin 3X Per DayDizziness0 participants
300 mg Gabapentin Once Per Day at NightDizziness0 participants
Secondary

Dizziness

incidence of any dizziness reported by the participant reported.

Time frame: 24 hours after surgery.

Population: 24-hour dizinness

ArmMeasureValue (NUMBER)
No GabapentinDizziness0 participants
300 mg Gabapentin 3X Per DayDizziness0 participants
300 mg Gabapentin Once Per Day at NightDizziness0 participants
Secondary

Hospital Length of Stay

timeframe from start of surgery to time of discharge (up to 24 days)

Time frame: From the date of surgery to date of hospital discharge (up to 24 days)

Population: Hospital Length of Stay per days

ArmMeasureValue (MEAN)
No GabapentinHospital Length of Stay6.4 days
300 mg Gabapentin 3X Per DayHospital Length of Stay5.6 days
300 mg Gabapentin Once Per Day at NightHospital Length of Stay6.5 days
Secondary

Incidence of Falls

Participants with one or more falls

Time frame: As they occur up to 96 hours after surgery.

Population: Incidence of falls

ArmMeasureValue (NUMBER)
No GabapentinIncidence of Falls0 participants
300 mg Gabapentin 3X Per DayIncidence of Falls0 participants
300 mg Gabapentin Once Per Day at NightIncidence of Falls0 participants
Secondary

Opioid Usage

opioid usage will be collected from electronically medical record as documented by nursing staff administering the medications.

Time frame: 24 hour after surgery.

Population: 24-hour Opioid use

ArmMeasureValue (MEAN)
No GabapentinOpioid Usage62.6 morphine equivalent dose-mg/kg
300 mg Gabapentin 3X Per DayOpioid Usage32.9 morphine equivalent dose-mg/kg
300 mg Gabapentin Once Per Day at NightOpioid Usage31.9 morphine equivalent dose-mg/kg
Secondary

Opioid Usage

opioid usage will be collected from electronically medical record as documented by nursing staff administering the medications.

Time frame: 1 hour after surgery.

Population: 1-hour Opioid use

ArmMeasureValue (MEAN)
No GabapentinOpioid Usage28.2 morphine equivalent dose-mg/kg
300 mg Gabapentin 3X Per DayOpioid Usage10.8 morphine equivalent dose-mg/kg
300 mg Gabapentin Once Per Day at NightOpioid Usage16.7 morphine equivalent dose-mg/kg
Secondary

Opioid Usage

opioid usage will be collected from electronically medical record as documented by nursing staff administering the medications.

Time frame: 48 hour after surgery.

Population: 48-hour opioid use

ArmMeasureValue (MEAN)
No GabapentinOpioid Usage63.9 morphine equivalent dose-mg/kg
300 mg Gabapentin 3X Per DayOpioid Usage36.2 morphine equivalent dose-mg/kg
300 mg Gabapentin Once Per Day at NightOpioid Usage106.4 morphine equivalent dose-mg/kg
Secondary

Opioid Usage

opioid usage will be collected from electronically medical record as documented by nursing staff administering the medications.

Time frame: 72 hour after surgery.

Population: 72-hour opioid use

ArmMeasureValue (MEAN)
No GabapentinOpioid Usage64.7 morphine equivalent dose-mg/kg
300 mg Gabapentin 3X Per DayOpioid Usage44.9 morphine equivalent dose-mg/kg
300 mg Gabapentin Once Per Day at NightOpioid Usage74.1 morphine equivalent dose-mg/kg
Secondary

Opioid Usage

opioid usage will be collected from electronically medical record as documented by nursing staff admisterning the medications.

Time frame: 96 hour after surgery.

Population: 96-hour opioid

ArmMeasureValue (MEDIAN)
No GabapentinOpioid Usage59.6 morphine equivalent dose-mg/kg
300 mg Gabapentin 3X Per DayOpioid Usage22.5 morphine equivalent dose-mg/kg
300 mg Gabapentin Once Per Day at NightOpioid Usage128.5 morphine equivalent dose-mg/kg
Secondary

Pulmonary Complications

any incidence of increase oxygen requirements or respiratory depression will be recorded

Time frame: As they occur up to 96 hours after surgery.

Population: Pulmonary Complications

ArmMeasureValue (NUMBER)
No GabapentinPulmonary Complications0 participants
300 mg Gabapentin 3X Per DayPulmonary Complications0 participants
300 mg Gabapentin Once Per Day at NightPulmonary Complications0 participants
Secondary

Sedation Scores

Sedation is measured as minimum to maximum awareness; high value worse to less awareness (awake/alert, quietly awake, asleep but arousable, deep sleep)

Time frame: 24 hour after surgery.

Population: 24-hour sedation scores 0=awake/alert; 1=quietly awake; 2=asleep/arousable; 3=deep sleep

ArmMeasureValue (MEAN)
No GabapentinSedation Scores0.7 units on a scale
300 mg Gabapentin 3X Per DaySedation Scores0 units on a scale
300 mg Gabapentin Once Per Day at NightSedation Scores0 units on a scale
Secondary

Sedation Scores

Sedation is measured as minimum to maximum awareness; high value worse to less awareness (awake/alert, quietly awake, asleep but arousable, deep sleep)

Time frame: 48 hour after surgery.

Population: 48-hour sedation scores 0=awake/alert; 1=quietly awake; 2=asleep/arousable; 3=deep sleep

ArmMeasureValue (MEAN)
No GabapentinSedation Scores0.17 units on a scale
300 mg Gabapentin 3X Per DaySedation Scores0 units on a scale
300 mg Gabapentin Once Per Day at NightSedation Scores0 units on a scale
Secondary

Sedation Scores

Sedation is measured as minimum to maximum awareness; high value worse to less awareness (awake/alert, quietly awake, asleep but arousable, deep sleep)

Time frame: 72 hour after surgery.

Population: 72-hour sedation scores 0=awake/alert; 1=quietly awake; 2=asleep/arousable; 3=deep sleep

ArmMeasureValue (MEAN)
No GabapentinSedation Scores0.17 units on a scale
300 mg Gabapentin 3X Per DaySedation Scores0 units on a scale
300 mg Gabapentin Once Per Day at NightSedation Scores0 units on a scale
Secondary

Sedation Scores

Sedation is measured as minimum to maximum awareness; high value worse to less awareness (awake/alert, quietly awake, asleep but arousable, deep sleep)

Time frame: 96 hour after surgery.

Population: 96-hour sedation scores 0=awake/alert; 1=quietly awake; 2=asleep/arousable; 3=deep sleep

ArmMeasureValue (MEAN)
No GabapentinSedation Scores0.17 units on a scale
300 mg Gabapentin 3X Per DaySedation Scores0 units on a scale
300 mg Gabapentin Once Per Day at NightSedation Scores0 units on a scale
Secondary

Sedation Scores

Sedation is measured as minimum to maximum awareness; high value worse to less awareness (awake/alert, quietly awake, asleep but arousable, deep sleep)

Time frame: 1hour after surgery.

Population: 1-hour sedation scores 0=awake/alert; 1=quietly awake; 2=asleep/arousable; 3=deep sleep

ArmMeasureValue (MEAN)
No GabapentinSedation Scores2 units on a scale
300 mg Gabapentin 3X Per DaySedation Scores1.3 units on a scale
300 mg Gabapentin Once Per Day at NightSedation Scores2 units on a scale
Secondary

Time to First Opioid Request

the timeframe between end of surgery to first opioid request

Time frame: As it first occurs, up to 96 hours after surgery

Population: first opioid request

ArmMeasureValue (MEAN)
No GabapentinTime to First Opioid Request6.86 hours
300 mg Gabapentin 3X Per DayTime to First Opioid Request8.67 hours
300 mg Gabapentin Once Per Day at NightTime to First Opioid Request5.32 hours
Secondary

Visual Disturbance

incidence of any visual disturbance reported by the participants will be reported.

Time frame: 48 hours after surgery.

Population: 48-hour vusual disturbances

ArmMeasureValue (NUMBER)
No GabapentinVisual Disturbance0 participants
300 mg Gabapentin 3X Per DayVisual Disturbance0 participants
300 mg Gabapentin Once Per Day at NightVisual Disturbance0 participants
Secondary

Visual Disturbance

incidence of any visual disturbance reported by the participants will be reported.

Time frame: 24 hours after surgery.

Population: 24-hour visual disturbances

ArmMeasureValue (NUMBER)
No GabapentinVisual Disturbance0 participants
300 mg Gabapentin 3X Per DayVisual Disturbance0 participants
300 mg Gabapentin Once Per Day at NightVisual Disturbance0 participants
Secondary

Visual Disturbance

incidence of any visual disturbance reported by the participants will be reported.

Time frame: 96 hours after surgery.

Population: 96-hour visual disturbances

ArmMeasureValue (NUMBER)
No GabapentinVisual Disturbance0 participants
300 mg Gabapentin 3X Per DayVisual Disturbance0 participants
300 mg Gabapentin Once Per Day at NightVisual Disturbance0 participants
Secondary

Visual Disturbance

incidence of any visual disturbance reported by the participants will be reported.

Time frame: 72 hours after surgery.

Population: 72-hour visual disturbances

ArmMeasureValue (NUMBER)
No GabapentinVisual Disturbance0 participants
300 mg Gabapentin 3X Per DayVisual Disturbance0 participants
300 mg Gabapentin Once Per Day at NightVisual Disturbance0 participants

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026