Preoperative Gabapentin for Cosmetic Breast Surgery

Postoperative Pain Clinical Trial

Official title:

"Preoperative Gabapentin and Its Effects on Postoperative Analgesia in Patients Undergoing Cosmetic Breast Surgery"

Clinical Trial Details — Status: Not yet recruiting

Administrative data

• NCT number: NCT05997355
• Other study ID #: B3650222
• Status: Not yet recruiting
• Phase: N/A
• Start date: September 1, 2023
• Est. completion date: July 31, 2024

Study information

• Verified date: August 2023
• Source: University of Puerto Rico
• Contact: Miguel A Serpa Irizarry, MD
• Phone: 7876430397
• Email: miguel.serpa[@]upr.edu
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The goal of this clinical trial is to compare postoperative pain and opioid consumption in patients who undergo cosmetic breast surgery and are treated preoperatively with gabapentin. The main questions to answer are the amount of postoperative pain on a scale of 0-10 and amount of opioids consumed postoperatively. Participants will be randomized into two groups: treatment vs no treatment. Treatment group will receive 600mg of gabapentin preopreatively. Researchers will compare treatment vs no treatment group to determine the effects of preoperative gabapentin on postoperative pain management and opioid consumption.

Description:

HYPOTHESIS We hypothesize that a single dose of preoperative gabapentin will improve postoperative pain scores and decrease postoperative opioid requirements in our study population. This will be tested by administering a preoperative dose of 600mg of gabapentin and measuring pain scores and amount of opioid consumption during the postoperative period. The study will compare two groups. Participants will be randomly assigned to one of the two groups and will consist of a treatment group and a control group. We will measure pain scores in a simple 0-10 scale and amount of opioid consumption during the first 7 days after discharge and compare them with patients who did not receive preoperative gabapentin. Our aims are to determine if gabapentin improves postoperative analgesia and reduces postoperative opioid requirements in a population undergoing cosmetic breast surgery

METHODOLOGY AND STUDY DESIGN

This study will be a randomized control trial. Participants will be randomized and divided into treatment versus no treatment group. Treatment group will be administered a dose of 600mg of gabapentin within 2 hours of surgery. Amount of postoperative opioids will be measured for 7 days, post op pain scores will be measured twice daily for 7 days. This information will be collected via postoperative questionnaires.

STUDY SUBJECTS Participants will be adult, non pregnant patients older than 18 years undergoing cosmetic breast surgery at either Hospital Oncologico Isaac Gonzalez Martinez or Hospital UPR Federico Trilla. Participants will be selected during the initial clinic visit, there will be no specific recruiting strategies. Excluded populations include minors 18 years old or less as well as pregnant females due to health concerns. Participants will be explained in detail the goal and objectives of study along with risks vs benefits. The following HIPAA identifiers will be excluded: Geographical elements, fax numbers, social security numbers, health insurance beneficiary numbers, vehicle identifiers, digital identifiers, digital attributes, IP addresses, biometric elements and full face photographic images.

VARIABLES

Primary outcomes will be the amount of postoperative pain and amount of postoperative opioid consumption. Postoperative pain will be defined and measured as a score from 1-10. Opioid consumption will be defined and measured as the amount of standard doses used in the postoperative period. Prior chronic gabapentin or opioid use will also be a variable accounted for to eliminate confounding effects of tachyphylaxis.

ANALYTIC PLAN Data will be organized in tables and analyzed with simple t-test to compare mean pain scores and amount of postoperative opioid consumption. Data will be stored within a shared google drive folder in a private excel/google sheets document. Each researcher listed in the study protocol will have access to the data individually via their own electronic devices in order to access when needed. CO-PI will administer privacy settings and provide access to each researcher. Data checks will periodically be performed to ensure data consistency.

Recruitment information / eligibility

• Status: Not yet recruiting
• Enrollment: 100
• Est. completion date: July 31, 2024
• Est. primary completion date: July 31, 2024
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 18 Years to 65 Years

Eligibility

Inclusion Criteria:

• adults 18 to 65 y/o without chronic gabapentin and/or opioid use

Exclusion Criteria:

• minors less than 18 y/o, adults older than 65 y/o, chronic users of gabapentin and/or opioids, pregnant females

Related Conditions & MeSH terms

• Opioid Use
• Pain, Postoperative
• Postoperative Pain

Intervention

Drug:
• Gabapentin 600Mg Tab
A single preoperative dose of gabapentin 600mg

Locations

Country	Name	City	State
n/a

Sponsors (1)

Lead Sponsor	Collaborator
University of Puerto Rico

References & Publications (9)

Barker JC, DiBartola K, Wee C, Andonian N, Abdel-Rasoul M, Lowery D, Janis JE. Preoperative Multimodal Analgesia Decreases Postanesthesia Care Unit Narcotic Use and Pain Scores in Outpatient Breast Surgery. Plast Reconstr Surg. 2018 Oct;142(4):443e-450e. doi: 10.1097/PRS.0000000000004804. — View Citation

Chang CY, Challa CK, Shah J, Eloy JD. Gabapentin in acute postoperative pain management. Biomed Res Int. 2014;2014:631756. doi: 10.1155/2014/631756. Epub 2014 Apr 14. — View Citation

Dirks J, Fredensborg BB, Christensen D, Fomsgaard JS, Flyger H, Dahl JB. A randomized study of the effects of single-dose gabapentin versus placebo on postoperative pain and morphine consumption after mastectomy. Anesthesiology. 2002 Sep;97(3):560-4. doi: 10.1097/00000542-200209000-00007. — View Citation

Freedman BM, O'Hara E. Pregabalin has opioid-sparing effects following augmentation mammaplasty. Aesthet Surg J. 2008 Jul-Aug;28(4):421-4. doi: 10.1016/j.asj.2008.04.004. — View Citation

Hu J, Huang D, Li M, Wu C, Zhang J. Effects of a single dose of preoperative pregabalin and gabapentin for acute postoperative pain: a network meta-analysis of randomized controlled trials. J Pain Res. 2018 Nov 2;11:2633-2643. doi: 10.2147/JPR.S170810. eCollection 2018. — View Citation

Liu B, Liu R, Wang L. A meta-analysis of the preoperative use of gabapentinoids for the treatment of acute postoperative pain following spinal surgery. Medicine (Baltimore). 2017 Sep;96(37):e8031. doi: 10.1097/MD.0000000000008031. — View Citation

Mao Y, Wu L, Ding W. The efficacy of preoperative administration of gabapentin/pregabalin in improving pain after total hip arthroplasty: a meta-analysis. BMC Musculoskelet Disord. 2016 Aug 30;17(1):373. doi: 10.1186/s12891-016-1231-4. — View Citation

Rai AS, Khan JS, Dhaliwal J, Busse JW, Choi S, Devereaux PJ, Clarke H. Preoperative pregabalin or gabapentin for acute and chronic postoperative pain among patients undergoing breast cancer surgery: A systematic review and meta-analysis of randomized controlled trials. J Plast Reconstr Aesthet Surg. 2017 Oct;70(10):1317-1328. doi: 10.1016/j.bjps.2017.05.054. Epub 2017 Jun 9. — View Citation

Seib RK, Paul JE. Preoperative gabapentin for postoperative analgesia: a meta-analysis. Can J Anaesth. 2006 May;53(5):461-9. doi: 10.1007/BF03022618. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Postoperative pain	Amount of postoperative pain on a scale from 1-10	Days 1-7 postoperatively
Primary	Postoperative opioid consumption	Amount of postoperative standardized opioid doses	Days 1-7 postoperatively