Friday, June 3, 2011

Effective and Safe gabapentin Suppress Nausea and Vomiting After Laparoscopic cholecystectomy

Gabapentin, which has a structure similar to GABA (gamma aminobutyric acid) is an antiepileptic drug turned out to have the potential to mencehan PONV. Gabapentin after absorbed and entered in the plasma is not bound to plasma proteins and is also not metabolized. Gabapentin 300 mg single dose given orally had maximum levels that occur after 2-3 hours. With a bioavailability of approximately 60% and increased with increasing dose. Gabapentin elimination through renal clearance and elimination half-life of approximately 5-7 hours after administration of single doses of 200-400 mg orally. From the initial studies indicate that gabapentin has potential as an antiemetic in patients with acute vomiting induced by chemotherapy (24 hours) or with a late onset (day-to-2 until the 5th) after chemotherapy.


Another study is a study that showed the potential of gabapentin in preventing PONV. Studies conducted studies Pandey CK, et al. and published in the Journal of Postgraduate Medicine, involved 250 patients who will get into action this laparoscopic cholecystectomy in ASA I and II degrees. Patients then performed the randomization to receive gabapentin or placebo (the number of these samples with the assumption that the incidence of PONV occurs in 70%), with gabapentin therapy will decrease by 20% and 90% power with the number of samples obtained by each group of 125 patients. Anesthesia was induced with propofol 2 mg / kg, fentanyl 3 ug / kg. And tracheal intubation facilitated with muscle relaxant vecuronium bromide 800 ug / kg. Anesthesia maintained with propofol infusion of 100-200 ug / kg / min and nitrous oxide 70% in oxygen. Setelak opersi action is completed the patient is given atropine blockade of muscle is 0.02 mg / kg and neostigmine 0.04 mg / kg. And parameters measured were the frequency and degree of PONV are included: did not happen PONV, PONV mild, moderate and severe, and the total use of fentanyl.

The results of these studies indicate that the incidence of PONV within 24 hours after laparoscopic cholecystectomy in bermakan action lower in the group who received gabepentin 37.8% (46/125) when compared with the group that received placebo 60% (75/125) with p = 0.04. The use of fentanyl was also lower in the group who received gabapentin (221.2 ± 92.4 ug) were compared with placebo (505.9 ± 82.0 ug) with the degree of significance of 0.01.

From the above study authors concluded that gabapentin effectively reduces nausea and vomiting after laparoscopic cholecystectomy action and reduce the need for analgesic pasaca operative action.

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