Safety of gabapentin versus celecoxib as a part of multimodal analgesia in patients with elective spine fixation surgery, A comparative randomized control study

Abstract

Background: Inadequate pain control after lumbar disc herniation surgeries may increase morbidity; leading to prolonged hospital stays, and increase medical costs. The anti-epileptic drugs such as gabapentin and other non-steroidal anti-inflammatory drugs (NSAID) such as celecoxib were used as a part of multimodal analgesia to control such pain. Aim of the study; The aim of this randomized double-blinded study was to asses and compare the efficacy of using gabapentin versus celecoxib as a part of multi modal analgesia in perioperative hemodynamic control and pain relief in patients underwent posterior approach lumbar spine disc surgery. Methods: A prospective, comparative blinded randomized study was carried out on one hundred patients of both gender, ASA I and II, aged between 21-60 years old scheduled to undergo elective posterior approach lumbar spine disc surgery. Patients were randomly assigned into two groups (50 patients each); Group (G) received gabapentin 300 mg capsule 2 hours preoperative and the same dose 6 hours postoperative and Group (C) received celecoxib 200 mg 2 hours preoperative and the same dose 6 hours postoperative. Intra operative hemodynamics and post-operative following parameters were recorded; mean arterial pressure, heart rate, respiratory rate, Visual Analogue score and Patient satisfaction score: at the end of postoperative period. Results: No significant difference was found in demographic data between both groups. Gabapentin administration associated with a better control of intra and post-operative mean arterial pressure and heart rate P values were (p<0.016) (p<0.018) respectively when compared to celecoxib. Regarding VAS scores in both groups there was decrease but more significant in Group (G) especially in first 8 hours (p<0.001). the same as satisfaction score. Conclusion: We concluded that both Gabapentin and celecoxib provide pain relief and good hemodynamic control when administered perioperatively but Gabapentin provide much better patient’s satisfaction after elective spine fixation surgeries.