The Effect of Oral Preoperative Use of Gabapentin and Pregabalin on Spinal Anesthesia Characteristics and Side Effects: A Comparative Randomized Clinical Trial

Razavizadeh, Mohammad Reza; Mahdian, Mehrdad; Barzegar, Niloofar; Akbari, Hossein

[Home ] [Archive]

[ فارسی ]

Journal of Ilam University of Medical Sciences

Main Menu

Home

Journal Information

Articles archive

Publication Ethics

Peer Review Process

Indexing Databases

For Authors

For Reviewers

Subscription

Contact us

Site Facilities

Google Scholar Metrics

Search in website

Receive site information

Registered in

Volume 33, Issue 4 (9-2025)

Journal of Ilam University of Medical Sciences 2025, 33(4): 79-89

Back to browse issues page

The Effect of Oral Preoperative Use of Gabapentin and Pregabalin on Spinal Anesthesia Characteristics and Side Effects: A Comparative Randomized Clinical Trial

Mohammad Reza Razavizadeh¹

, Mehrdad Mahdian ^*²

, Niloofar Barzegar¹

, Hossein Akbari³

1- Anesthesiology Department, Medical School, Kashan University of Medical Sciences, Kashan, Iran
2- Trauma Research Center, Kashan University of Medical Sciences, Kashan, Iran , mmahdian78@gmail.com
3- Social Determinants of Health Center, Kashan University of Medical Sciences, Kashan, Iran

Abstract: (33 Views)

Introduction: This study was conducted with the aim of comparing the effects of gabapentin and pregabalin on the characteristics and side effects of spinal anesthesia in patients undergoing surgery below the umbilical level.
Materials & Methods: This double-blind clinical trial study was conducted on 72 patients with ASA CLASS I or II who underwent surgery below the umbilical level (T10) with spinal anesthesia. The patients were randomly divided into 3 groups receiving oral gabapentin (300 mg), pregabalin (150 mg), and placebo. The onset and duration of anesthesia, decrease in arterial blood pressure and heart rate, nausea and vomiting, postoperative pain, and post-dural puncture headache (PDPH) of the patients were investigated in SPSS V.18 at a significance level of less than 0.05.
Results: There were no significant differences among the study groups in demographic characteristics. Postoperative pain, headache, hypotension, bradycardia, nausea and vomiting, and the onset time of sensory block were not significantly different between the groups. The mean postoperative pain scores were 6.08 in the gabapentin group, 6.04 in the pregabalin group, and 7.58 in the control group, with the control group reporting significantly higher pain (P<0.05). There was no significant difference between gabapentin and pregabalin in terms of pain scores. The mean duration of sensory block was 265.6 minutes for gabapentin, 322.7 minutes for pregabalin, and 218.3 minutes for the control group. Pregabalin significantly prolonged the sensory block compared to gabapentin (P<0.05).
Conclusion: The beginning of the sensory block at the T10 level was shorter, and the duration of the sensory block was significantly longer in the pregabalin group than in the gabapentin group. No significant difference was observed in other variables.

Keywords: gabapentin, pregabalin, spinal anesthesia

Full-Text [PDF 753 kb] (24 Downloads)

Type of Study: Research | Subject: anesthesia
Received: 2024/11/13 | Accepted: 2025/08/19 | Published: 2025/09/27

References

1. Carness JM, Lenart MJ. Current local anesthetic applications in regional anesthesia. Topics in Local Anesthetics: IntechOpen; 2019. doi: 10.5772/intechopen.88528.

2. Mitra J, Roy J, Bhattacharyya P, Yunus M, Lyngdoh N. Changing trends in the management of hypotension following spinal anesthesia in cesarean section. J Postgrad Med. 2013;59:121. doi: 10.4103/0022-3859.113840.

3. Acosta JAH, Hidalgo FOZ, León MFC, Castañeda JJ. Complications in Spinal Anesthesia. Advances in Regional Anesthesia-Future Directions in the Use of Regional Anesthesia: IntechOpen; 2024. doi: 10.5772/intechopen.1002927.

4. Biava AM, Cipriani G, Malja E, Bilotta F. Vasopressors for hypotension in spinal anesthesia for cesarean section. J Anesth. 2025;39:155-6. doi: 10.1007/s00540-024-03392-8.

5. Zhao-Fleming H, Hand A, Zhang K, Polak R, Northcut A, Jacob D, et al. Effect of non-steroidal anti-inflammatory drugs on post-surgical complications against the backdrop of the opioid crisis. Burns trauma. 2018;6. doi: 10.1186/s41038-018-0128-x.

6. Jain N, Phillips FM, Weaver T, Khan SN. Preoperative chronic opioid therapy: a risk factor for complications, readmission, continued opioid use and increased costs after one-and two-level posterior lumbar fusion. Spine. 2018;43:1331-8. doi: 10.1097/BRS.0000000000002609.

7. Meitei AJ, Singh YA, Ingudum D. Effects of Pre-emptive Gabapentin Versus Pregabalin on Acute Post-operative Pain after Surgery under Spinal Anaesthesla. Int J Acad Med Pharm. 2024;6:113-7. doi: 10.47009/jamp.2024.6.1.22.

8. Mordeniz C, Ozdemir F, Karaarslan N, Yıldırım I, Demirkapu MJ, Arar MC. Pre-emptive analgesia with preoperative oral gabapentin and pregabalin in lumbar narrow canal surgery. Signa Vitae. 2024;20:1-12. doi:10.22514/sv.2024.091.

9. Baranowska J, Szeleszczuk Ł. Exploring Various Crystal and Molecular Structures of Gabapentin—A Review. Crystals. 2024;14:257. doi: 10.3390/cryst14030257.

10. Rusciano D. Molecular mechanisms and therapeutic potential of gabapentin with a focus on topical formulations to treat ocular surface diseases. Pharmaceuticals. 2024;17:623. doi: 10.3390/ph17050623.

11. Martínez-Campos Z, Hernandez-Dominguez LE, Romero-Rivera F, López-López D, Corona-González MV, López-Cortina ST, et al. Synthesis and In Silico Evaluation of GABA, Pregabalin and Baclofen N-Heterocyclic Analogues as GABAB Receptor Agonists. Organics. 2025;6:13. doi: 10.3390/org6020013.

12. Doo J. The Effect of Gabapentin on Post-Operative Pain in Minimally Invasive Sacrocolpopexy: A Randomized Controlled Pilot Study (Master's thesis, The University of Oklahoma Health Sciences Center).

13. Memari F, Jadidi R, Noroozi A, Mohammadbeigi A, Falahati J. Protecting effect of gabapentin for nausea and vomiting in the surgery of cesarean after spinal anesthesia. Anesth Essays Res. 2015;9:401. doi: 10.4103/0259-1162.157469.

14. Giakas JA, Israel HA, Ali AH, Kaar SG. Does the addition of post-operative gabapentin reduce the use of narcotics after orthopedic surgery? Phys Sportsmed. 2024;52:283-90. doi: 10.1080/00913847.2023.2246177.

15. Alimian M, Imani F, Faiz SH-R, Pournajafian A, Navadegi SF, Safari S. Effect of oral pregabalin premedication on post-operative pain in laparoscopic gastric bypass surgery. Anesth Pain Med. 2012;2:12. doi: 10.5812/aapm.4300.

16. Casellato JF, Balki M, Wang A, Ye XY, Downey K, Carvalho JC. Differential sensory block during labour epidural analgesia: a prospective observational study to investigate the relationship of lower and upper sensory block levels to cold, pinprick, and light touch. Can J Anaesth. 2024;71:802-7. doi: 10.1007/s12630-023-02638-5.

17. Minusa S, Matsumura T, Esaki K, Shao Y, Yoshimura C, Mizuno H. Response Style Characterization for Repeated Measures Using the Visual Analogue Scale. IEEE Access. 2024. doi: 10.1109/ACCESS.2024.3445410.

18. Huseyinoglu U, Huseyinoglu N, Hamurtekin E, Aygun H, Sulu B. Effect of pregabalin on post-dural-puncture headache following spinal anesthesia and lumbar puncture. J Clin Neurosci. 2011;18:1365-8. doi: 10.1016/j.jocn.2011.02.029.

19. Avci G, Alemdar NK. The Effects and Comparative Efficacy of Dexamethasone and Gabapentin on Nausea and Vomiting after Laparoscopic Cholecystectomy. JARSS. 2024;32: 96-102. doi: 10.54875/jarss.2024.50251.

20. Söğüt MS, Yılmaz MÜ, Manici M, Karakaya MA, Divanlıoğlu BK, Darçın K. Effects of Gabapentin on Postoperative Pain Management After Spinal Surgery: A Systematic Review and Meta-analysis. Comprehen Med. 2024;16:198-212. doi: 10.14744/cm.2024.57441.

21. Pandey CK, Priye S, Ambesh S, Singh S, Singh U, Singh P. Prophylactic gabapentin for prevention of postoperative nausea and vomiting in patients undergoing laparoscopic cholecystectomy: a randomized, double-blind, placebo-controlled study. J Postgrad Med. 2006;52:97.

22. Anderson DE, Duletzke NT, Pedigo EB, Halsey MF. Multimodal pain control in adolescent posterior spinal fusion patients: a double-blind, randomized controlled trial to validate the effect of gabapentin on postoperative pain control, opioid use, and patient satisfaction. Spine Deform. 2020;8:177-85. doi: 10.1007/s43390-020-00038-z.

23. Heybati K, Zhou F, Lynn MJ, Deng J, Ali S, Hou W, et al. Comparative efficacy of adjuvant nonopioid analgesia in adult cardiac surgical patients: a network meta-analysis. J Cardiothorac Vasc Anesth. 2023;37:1169-78. doi: 10.1053/j.jvca.2023.03.018.

24. Sihoe AD, Lee TW, Wan IY, Thung KH, Yim AP. The use of gabapentin for post-operative and post-traumatic pain in thoracic surgery patients. Eur J Cardiothorac Surg. 2006;29:795-9. doi: 10.1016/j.ejcts.2006.02.020.

25. Abdelsami Aiad A, Gaballah KM, Sultan WA. Perioperative oral pregabalin or clonidine in patients undergoing lumbar spine posterior fusion: A randomized controlled trial. Egypt J Anaesth. 2024;40:127-34. doi: TEJA-2024-0009.

26. Usman A, Mehdi SR, Khan AA. Preventive analgesia with oral tramadol and pregabalin for post-operative pain in breast surgical patients. Anaesthesia, Pain & Intensive Care. 2024;28(1):81-4.

27. Saraswat V, Arora V. Preemptive gabapentin vs pregabalin for acute postoperative pain after surgery under spinal anaesthesia. Indian J Anaesth. 2008;52:829-34. doi: 10.35975/apic.v28i1.2374.

28. Chen KY, Chan HC, Wei LY, Chan CM. Efficacy of gabapentin and pregabalin for treatment of post refractive surgery pain: a systematic review and meta-analysis. Int Ophthalmol. 2024;44:1-18. doi: 10.1007/s10792-024-03300-9.

29. Ruiz Ibán MÁ, Oteo-Álvaro Á, Miguéns Vázquez X, Ávila JL, Ribera H, Pérez-Páramo M. Efficacy and safety of pregabalin for postoperative pain after total hip and knee arthroplasty: a systematic review and meta-analysis. J Orthop Surg Res. 2025;20:261. doi: 10.1186/s13018-025-05675-6.

30. Rose M, Kam P. Gabapentin: pharmacology and its use in pain management. Anaesthesia. 2002;57:451-62. doi: 10.1046/j.0003-2409.2001.02399.x.

31. Bockbrader HN, Wesche D, Miller R, Chapel S, Janiczek N, Burger P. A comparison of the pharmacokinetics and pharmacodynamics of pregabalin and gabapentin. Clin Pharmacokinet. 2010;49:661-9. doi: 10.2165/11536200-000000000-00000.

32. Calandre EP, Rico-Villademoros F, Slim M. Alpha2delta ligands, gabapentin, pregabalin and mirogabalin: a review of their clinical pharmacology and therapeutic use. Expert Rev Neurother. 2016;16:1263-77. doi: 10.1080/14737175.2016.1202764.

33. Chincholkar M. Analgesic mechanisms of gabapentinoids and effects in experimental pain models: a narrative review. Br J Anaesth. 2018;120:1315-34. doi: 10.1016/j.bja.2018.02.066.

34. Pan Y, Davis PB, Kaebler DC, Blankfield RP, Xu R. Cardiovascular risk of gabapentin and pregabalin in patients with diabetic neuropathy. Cardiovasc Diabetol. 2022;21:170. doi: 10.1186/s12933-022-01610-9.

35. Karami T, Hoshyar H, Jafari AF. The effect of pregabalin on postdural puncture headache among patients undergoing elective cesarean section: A randomized controlled trial. Ann Med Surg. 2021;64:102226. doi: 10.1016/j.amsu.2021.102226.

36. Najafi Anaraki A, Mirzaei K. Comparing the Prophylactic Effect of Pregabalin with that of Aminophylline Plus Dexamethasone on Postdural Puncture Headache after Spinal Anesthesia in Cesarean Section: A Double-Blind Controlled Randomized Clinical Trial. ISMJ. 2019;22:307-16. doi: 10.29252/ismj.22.5.307.

Send email to the article author

Add your comments about this article

Ethics code: IR.KAUMS.MEDNT.REC.1398.093

Mendeley

Zotero

RefWorks

Razavizadeh M R, Mahdian M, Barzegar N, Akbari H. The Effect of Oral Preoperative Use of Gabapentin and Pregabalin on Spinal Anesthesia Characteristics and Side Effects: A Comparative Randomized Clinical Trial. J. Ilam Uni. Med. Sci. 2025; 33 (4) :79-89
URL: http://sjimu.medilam.ac.ir/article-1-8445-en.html

Rights and permissions
	This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Volume 33, Issue 4 (9-2025)

Back to browse issues page

Persian site map - English site map - Created in 0.16 seconds with 39 queries by YEKTAWEB 4722