ORIGINAL ARTICLE
Year : 2014  |  Volume : 8  |  Issue : 3  |  Page : 317-322

Evaluation of gabapentin and dexamethasone alone or in combination for pain control after adenotonsillectomy in children


Department of Anesthesia, Tanta University Hospital, Faculty of Medicine, Tanta 31527, Egypt

Correspondence Address:
Dr. Sabry Mohammad Amin
Department of Anesthesia, Tanta University Hospital, Faculty of Medicine, Tanta 31527
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1658-354X.136417

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Background: Different methods and many drugs have been used to control the post-operative pain. In this study, we evaluate the role of gabapentin premedication and/or dexamethasone in management of post-operative pain following adenotonsillectomy in children. Materials and Methods: In a double-blind randomized study, 120 children were subjected for adenotonsillectomy classified into three equal groups. Group G: Gabapentin 10 mg/kg was given orally 2 h before induction of anesthesia (Gabapentin syrup 250 mg/5 ml. Group D: Children in this group received placebo pre-operatively and received dexamethasone 0.15 mg/kg intravenously after induction of anesthesia, but before surgery. Group C: Children in this group received combination of oral gabapentin 10 mg/kg 2 h before induction of anesthesia and intra-operative 0.15 mg/kg dexamethasone intravenously. All children underwent general anesthesia. Pain score was assisted post-operatively 2 h, 4 h, 6 h, 8 h, 12 h and 18 h after recovery using face, legs, activity, cry, consolability scale. Results: Pain score in Group C and Group G was significantly less at 4 h, 6 h and 8 h post-operatively than in Group D (P < 0.05). At 12 h, the pain score in Group C was significantly less than Group G and Group D (P < 0.05). And no significant changes were observed in pain score at 18 h post-operatively between all groups (P > 0.05). The time to first analgesia was longer in the Group C than in Group G and Group D and the time to first analgesia was significantly longer in Group G than in Group D (P < 0.05). The total amount of pethidine was less in Group C and Group G than in Group D (P < 0.05). The incidence of post-operative nausea and vomiting was statically insignificant among all groups and no reported post-operative bleeding. Conclusion: Gabapentin 10 mg/kg premedication combined with intra-operative dexamethasone 0.15 mg/kg prolongs the post-operative analgesia following adenotonsillectomy in children and decreases the amount of pethidine used post-operatively with no reported adverse effects or increase in the incidence of post-operative bleeding.


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