Background: Gabapentin is an anticonvulsant that has postoperative analgesic effects but there are limited studies on its postoperative administration.Objectives: The present study was conducted to evaluate the effect of the postoperative oral gabapentin on pain and morphine consumption.Patients and Methods: In a double blind, randomized study, 64 patients undergoing internal fixation of tibia under spinal anesthesia were randomly assigned to receive oral gabapentin or placebo immediately after the surgery. Pain scores were recorded at time points of 2, 12 and 24 hours postoperatively using visual analog scale (VAS). Time duration from the end of surgery until morphine administration and total morphine requirement in the first 24 hours were recorded.Results: The estimated duration of surgeries was 120-150 minutes. VAS score was not significantly different between the two groups at 2, 12 and 24 hours after surgery. There was no significant morphine consumption difference between the groups.Conclusions: Our study showed no significant analgesic efficacy of oral gabapentin 300 mg immediately after tibia internal fixation surgery under spinal anesthesia at time points of 2, 12 and 24 hours postoperatively.

The practice of modern anesthesiology has been developed from intraoperative period into perioperative period. Postoperative pain management is one of the most important components of adequate post-surgical patients care. This article wrote with the aim of emphasis on importance and effectiveness of Post-Operative pain management. Reading this article is beneficial for physicians, interventional pain managers and who care about pain medicine. Unrelieved acute pain after surgery usually elicits pathophysiologic neural alterations, including not only peripheral but also central sensitization which evolves into chronic pain syndromes. The main purpose of perioperative pain control is providing an adequate comfort level and acceptable side effects for patients. Effective postoperative analgesia improves patients’ outcome as observed by early ambulation, decrease in side effects, and reduce the incidence of postoperative chronic pain (1-3).

Pain has many adverse effects on all organ systems and its role is more important in postoperative conditions. Use of opioids for pain management results in various complications. Magnesium sulfate may play a role in postoperative pain management and reduce the opioid-consumption trend. We assessed this effect of magnesium sulfate. In a double blind randomized clinical trial 54 male patients in ASA class I undergoing general anesthesia for elective unilateral inguinal herniorrhaphy were randomly allocated in two equal groups who received 15mL of 20% magnesium sulfate (cases) or 15 mL saline (controls) intravenously after anesthesia induction. Surgical team and anesthetic protocol were identical. We measured postoperatively the intensity of pain [according to visual analog pain score(VAS)] in the first, 6th. 12th,and 24th hour after surgery and pethidine administration (that was prescribed on demand) during one day after surgery. Cases showed less pain intensity in the 6th h (p=0.026), 12th h (p<0.001) and 24thh (p=0.028) postop and received less pethidine (p=0.027). Side effects were statistically identical. In conclusion, administration of intravenous magnesium sulfate is associated with less pain and fewer analgesic requirements without any increase in side effects. Magnesium sulfate could be an interesting adjuvant for postoperative analgesia.