Effect of preoperative gabapentin on pain intensity and development of chronic pain after carpal tunnel syndrome surgical treatment in women: randomized, double-blind, placebo-controlled study

ABSTRACT CONTEXT AND OBJECTIVES: Effective postoperative analgesia is important for reducing the incidence of chronic pain. This study evaluated the effect of preoperative gabapentin on postoperative analgesia and the incidence of chronic pain among patients undergoing carpal tunnel syndrome surgical treatment. DESIGN AND SETTINGS: Randomized, double-blind controlled trial, Federal University of São Paulo Pain Clinic. METHODS: Forty patients aged 18 years or over were randomized into two groups: Gabapentin Group received 600 mg of gabapentin preoperatively, one hour prior to surgery, and Control Group received placebo. All the patients received intravenous regional anesthesia comprising 1% lidocaine. Midazolam was used for sedation if needed. Paracetamol was administered for postoperative analgesia as needed. Codeine was used additionally if the paracetamol was insufficient. The following were evaluated: postoperative pain intensity (over a six-month period), incidence of postoperative neuropathic pain (over a six-month period), need for intraoperative sedation, and use of postoperative paracetamol and codeine. The presence of neuropathic pain was established using the DN4 (Douleur Neuropathique 4) questionnaire. Complex regional pain syndrome was diagnosed using the Budapest questionnaire. RESULTS: No differences in the need for sedation, control over postoperative pain or incidence of chronic pain syndromes (neuropathic or complex regional pain syndrome) were observed. No differences in postoperative paracetamol and codeine consumption were observed. CONCLUSIONS: Preoperative gabapentin (600 mg) did not improve postoperative pain control, and did not reduce the incidence of chronic pain among patients undergoing carpal tunnel syndrome surgery.

Download Full-text

Postoperative Pain Management after Carpal Tunnel Syndrome Surgical Treatment: Comparing Practice with Guidelines

Acta Clinica Croatica ◽

10.20471/acc.2017.56.03.11 ◽

2017 ◽

Author(s):

Ivan Utrobičić

Keyword(s):

Surgical Treatment ◽

Pain Management ◽

Postoperative Pain ◽

Carpal Tunnel Syndrome ◽

Carpal Tunnel ◽

Postoperative Pain Management ◽

Tunnel Syndrome

Download Full-text

The Incidence of Complex Regional Pain Syndrome in Simultaneous Surgical Treatment of Carpal Tunnel Syndrome and Dupuytren Contracture

Hand ◽

10.1177/1558944717718345 ◽

2017 ◽

Vol 13 (4) ◽

pp. 391-394 ◽

Cited By ~ 4

Author(s):

Mitchell Buller ◽

Steven Schulz ◽

Morton Kasdan ◽

Bradon J. Wilhelmi

Keyword(s):

Surgical Treatment ◽

Carpal Tunnel Syndrome ◽

Complex Regional Pain Syndrome ◽

Carpal Tunnel ◽

Carpal Tunnel Release ◽

Group Versus ◽

Pain Syndrome ◽

Increased Risk ◽

Tunnel Syndrome ◽

Dupuytren Contracture

Background: To determine the incidence of complex regional pain syndrome (CRPS) in the concurrent surgical treatment of Dupuytren contracture (DC) and carpal tunnel syndrome (CTS) through a thorough review of evidence available in the literature. Methods: The indices of 260 hand surgery books and PubMed were searched for concomitant references to DC and CTS. Studies were eligible for inclusion if they evaluated the outcome of patients treated with simultaneous fasciectomy or fasciotomy for DC and carpal tunnel release using CRPS as a complication of treatment. Of the literature reviewed, only 4 studies met the defined criteria for use in the study. Data from the 4 studies were pooled, and the incidence of recurrence and complications, specifically CRPS, was noted. Results: The rate of CRPS was found to be 10.4% in the simultaneous treatment group versus 4.1% in the fasciectomy-only group. This rate is nearly half the 8.3% rate of CRPS found in a randomized trial of patients undergoing carpal tunnel release. Conclusions: Our analysis demonstrates a marginal increase in the occurrence of CRPS by adding the carpal tunnel release to patients in need of fasciectomy, contradicting the original reports demonstrating a much higher rate of CRPS. This indicates that no clear clinical risk is associated with simultaneous surgical treatment of DC and CTS. In some patients, simultaneous surgical management of DC and CTS can be accomplished safely with minimal increased risk of CRPS type 1.

Download Full-text

Preoperative use of gabapentin for pain reduction in open surgeries under local anesthesia for idiopathic bilateral carpal tunnel syndrome

Research Society and Development ◽

10.33448/rsd-v10i4.14506 ◽

2021 ◽

Vol 10 (4) ◽

pp. e54410414506

Author(s):

Sergio Murilo Georgeto ◽

Rodrigo Antônio Carvalho Andraus ◽

Ovídia Ignês Pires ◽

Eros de Oliveira Junior ◽

Karen Barros Parron Fernandes

Keyword(s):

Postoperative Pain ◽

Carpal Tunnel Syndrome ◽

Carpal Tunnel ◽

Surgical Procedure ◽

Placebo Control ◽

Double Blind Study ◽

Double Blind ◽

Degree Of Satisfaction ◽

Tunnel Syndrome ◽

Bilateral Carpal Tunnel Syndrome

This article aims to evaluate the preoperative use of gabapentin in the control of intra- and postoperative pain in patients with idiopathic bilateral carpal tunnel syndrome (CTS). A prospective, randomised, double-blind study involving 45 subjects with severe CTS, 23 receiving treatment (gabapentin 600 mg) and 22 receiving placebo (control), who underwent an open surgical approach in one hand under local anaesthesia. Information related to the patients’ profile, safety of the surgical procedure, history of pain, adverse effects, numbness, and medications used were collected during the 14 days of the procedure and evaluated by Generalised Estimated Equations and Generalised Linear Mixed Models. The treatment and control groups were homogeneous regarding the patients’ profile and surgical procedure data. The patients who used gabapentin 600 mg had a better evaluation during surgery (d = 0.655), anaesthesia (d = 0.854), and on the first night of sleep (d = 1.323), and they reported a higher degree of satisfaction with the surgery after 14 days (d = 1.091). The treatment group reported decreased pain in the operated hand in a 24-hour period (r = 0.34, 95% CI: 0.223–0.457) and in the 14-day follow-up period (r = 0.412, 95% CI: 0.217–0.608). These results were not impacted by the medications used and remained consistent over time. The use of a single dose of gabapentin 600 mg in the preoperative period proved to be safe and effective in reducing postoperative pain, and the improvement was noticed by the patient.

Download Full-text