Perioperative Gabapentin May Improve Pain Management in Head and Neck Cancer
The total morphine equivalents used were, however, not significantly different between arms.
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Perioperative gabapentin improves subjective pain scores, but may not reduce total narcotic use, among patients with head and neck cancer, according to data presented at the 2018 American Head & Neck Society Annual Meeting in National Harbor, Maryland.1
For this double-blinded study, researchers randomly assigned 90 patients undergoing head and neck mucosal surgery who planned to stay at least 1 night in the hospital to receive placebo or oral gabapentin 300 mg twice daily before surgery and for 3 days post-operatively. The visual analogue scale (VAS) subjective pain scale was completed 3 times a day to assess resting, coughing, and swallowing pain.
More patients in the gabapentin group had an Adult Comorbidity Evaluation (ACE)-27 score of “none” compared with the placebo group. According to self-reports, patients had similar levels of pain tolerance, daily pain, and narcotic effectiveness regardless of group assignment.
The total morphine equivalents used, and narcotics usage in the first, second, and third days after surgery were, however, not significantly different between the placebo and gabapentin groups, but trended towards significance after the third day.
A mixed-model analysis showed that VAS scores were significantly improved among patients in the gabapentin arm for all categories. Subjective satisfaction with pain management was improved, but not significantly, among patients in the gabapentin arm.
Nausea occurred at a slightly higher rate in the placebo arm vs gabapentin, and the rates of dizziness and sedation were similar between the 2 treatment arms.
The authors concluded that “this regimen is safe in terms of side effects, may reduce perception of pain, but is unlikely to change narcotic use.”
Read more of Cancer Therapy Advisor's coverage of the American Head & Neck Society (AHNS) 2018 meeting by visiting the conference page.
- Townsend ME, Liou T, Morgan S, et al. Perioperative gabapentin use among head and neck surgical patients. Oral presentation at: 2018 American Head & Neck Society Annual Meeting; April 18-19, 2018; National Harbor, MD.