Gabapentin for Perioperative Pain Management for Uterine Aspiration: A Randomized Controlled Trial.
Abstract
OBJECTIVE:To evaluate the effect of oral gabapentin in conjunction with usual oral
pain management regimens of lorazepam, ibuprofen, oxycodone, and acetaminophen for
surgical abortion on pain 5 minutes postprocedure. METHODS:This was a randomized,
double-blind, placebo-controlled trial of patients from 6 0/7-14 6/7 weeks of gestation
scheduled to undergo surgical abortion at the Duke Family Planning Clinic. Participants
were administered 600 mg of oral gabapentin compared with placebo with usual oral
pain management. Pain score was assessed using a 100-mm visual analog scale, with
the primary outcome being pain score 5 minutes after the procedure. The effect of
gabapentin was assessed using a linear regression model controlling for baseline pain.
We also measured pain perception 24 hours after the procedure. Secondary outcome measures
included anxiety, side effects, and usage of opiate pain medication in the 24-hour
postoperative period. RESULTS:Out of 113 women screened for this study; 96 women were
recruited, enrolled, and randomized to study treatment arm from August 2016 to June
2018. Pain at 5 minutes after the procedure was similar between the gabapentin and
placebo groups ((Equation is included in full-text article.)=3.40; 95% CI -8.20 to
15.0; P=.56). Gabapentin and placebo were well tolerated, with no statistically significant
difference in side effects or anxiety levels. Although prescription of opioids after
the procedure was not standardized among patients, 73% of women received a short-term
prescription for oxycodone. A lower percentage of women in the gabapentin group self-reported
taking opioids in the 24 hours postprocedure (18% vs 47%; odds ratio 0.26; 95% CI
0.09-0.75). CONCLUSION:The addition of gabapentin to usual oral pain management regimens
with paracervical block did not reduce postoperative pain for patients undergoing
outpatient surgical abortion. Although the addition of gabapentin was well tolerated
and reduced oral opiate use 24 hours postprocedure, it did not affect the experience
of pain during and immediately after the procedure. CLINICAL TRIAL REGISTRATION:ClinicalTrials.gov,
NCT02725710.
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https://hdl.handle.net/10161/19286Published Version (Please cite this version)
10.1097/aog.0000000000003398Publication Info
Gray, Beverly A; Hagey, Jill M; Crabtree, Donna; Wynn, Clara; Weber, Jeremy M; Pieper,
Carl F; & Haddad, Lisa B (2019). Gabapentin for Perioperative Pain Management for Uterine Aspiration: A Randomized
Controlled Trial. Obstetrics and gynecology, 134(3). pp. 611-619. 10.1097/aog.0000000000003398. Retrieved from https://hdl.handle.net/10161/19286.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Show full item recordScholars@Duke
Beverly Allen Gray
Associate Professor of Obstetrics and Gynecology
Carl F. Pieper
Professor of Biostatistics & Bioinformatics
Analytic Interests. 1) Issues in the Design of Medical Experiments: I explore the
use of reliability/generalizability models in experimental design. In addition to
incorporation of reliability, I study powering longitudinal trials with multiple outcomes
and substantial missing data using Mixed models. 2) Issues in the Analysis of Repeated
Measures Designs & Longitudinal Data: Use of Hierarchical Linear Models (HLM) or Mixed
Models in modeling trajectories of multipl
Jeremy Weber
Biostatistician III
Jeremy collaborates with clinicians, residents, and fellows in the Division of Pulmonary,
Allergy, and Critical Care Medicine in the Department of Medicine, and the Department
of Obstetrics and Gynecology. His research experience involves multilevel modeling,
lung transplantation studies, and working with national databases. His statistical
interests include longitudinal analysis, observational studies, and survival analysis.
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