Effect of prophylactic gabapentin on post operative nausea and vomiting after laparoscopic cholecystectomy: a randomized controlled trial

Background: Postoperative nausea and vomiting (PONV) is a frequent and unpleasant adverse event associated with surgery. The reported incidence of PONV after laparoscopic cholecystectomy (LC) is quite high. Despite the use of different drugs to prevent or relieve PONV, it continues to be undermanaged. Recently, studies have been undertaken to determine if gabapentin can be useful for the prevention of PONV. \r\nObjectives: We assessed the effect of perioperative gabapentin administration on PONV after LC. \r\nPatients and Methods: We enrolled 92 patients scheduled to undergo LC for a randomized double-blind placebo-controlled study. Patients were divided into two groups of 46 patients. The intervention group received two doses of 600 mg gabapentin: one dose two hours before surgery and one dose six hours after surgery. Similarly Control group received capsules in the same size and shape as gabapentin capsules. All Patients were observed for PONV and adverse effects of the drug for 24 h. Metoclopramid (10 mg) was used as the antiemetic in patients with severe PONV in necessary circumstances. Total metoclopramid consumption were recorded. \r\nResults: There were no demographic differences between the 2 study groups. Within 24 h of LC, 12 patients who received gabapentin (26.1%) and 30 patients who received a placebo (65.2%) experienced nausea (P < 0.001), while 10 patients in the intervention group (21.7%) and 24 patients in the control group (52.3%) vomited (P = 0.002). Metoclopramid was used to control PONV in 11 intervention patients (23.9%) and 29 control patients (63%; P = 0.001). \r\nConclusions: Perioperative administration of gabapentin significantly decreases the incidence of PONV and the requirement for postoperative antiemetic treatment following LC.