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ORIGINAL ARTICLE
Year : 2016  |  Volume : 3  |  Issue : 3  |  Page : 109-115

Combined gabapentin–celecoxib premedication as a part of multimodal analgesia for liposuction under monitored anesthesia care


1 Department of Anaesthesia and Intensive Care, Faculty of Medicine, Zagazig University, Zagazig, Egypt
2 Department of General Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt

Correspondence Address:
Ali M Elnabtity
Elnabtity, MD in Anesthesia and Intensive Care, Faculty of Medicine, Zagazig University, Saudi Arabia, Jeddah, Palesteen Street, PO Box: 2537, Jeddah, 21461
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2356-9115.193409

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Aim The aim of this study was to evaluate the analgesic effect of gabapentin when combined with celecoxib on tumescent anesthesia during liposuction,aided by conscious i.v. sedation/analgesia. Background Multimodal analgesia is an essential part of monitored anesthesia care during liposuction. This prospective r andomized double-blinded controlled trial was designed to investigate the hypothesis that premedication with gabapentin and celecoxib can increase the analgesic efficacy of tumescent anesthesia and decrease the i.v. sedative/analgesic requirements during and after monitored anesthesia care for liposuction procedures. Methods Sixty-four patients (American Society of Anesthesiologist I and II) aged 18–50 years and undergoing liposuction were studied. The patients were randomly allocated into two groups: group I (control group, n = 31) and group II (gabapentin–celecoxib group, n = 33). Two hours before the procedure, patients of group I received oral placebo, and those of group II received oral gabapentin 1200 mg and celecoxib 400 mg. After standard premedication, sedation was maintained by a continuous infusion of propofol adjusted to achieve a Ramsay sedation scale score of 2–3. Intraoperative analgesia was maintained by incremental doses of i.v. ketamine 25–50 mg along with tumescent anesthesia at the operative site. Postoperative pain was managed by i.v. paracetamol at 1g/6 h. Meperidine 25–100 mg i.v. was administered as rescue analgesia. Intraoperative verbal rating scale scores for pain were assessed at 5 and 15 min and then every 15 min until the end of surgery. The total amount of intraoperative propofol and ketamine consumed was recorded. Postoperative visual analog scale for pain and Ramsay sedation score were assessed every 2 h and their worst values at intervals of 0–4, 4–8, and 8–12 h were considered for analysis. The total amount of meperidine consumed 12 h postoperatively and the time to first rescue analgesia request were recorded. Results Intraoperative pain scores at 90 and 120 min as well as the worst postoperative pain scores at intervals of 0–4 and 8–12 h were significantly lower in the gabapentin–celecoxib group. Ketamine (1.733 ± 0.398 vs. 01.996 ± 0.56mg/kg; P < 0.05) and meperidine (22.73 ± 33.29 vs. 83.87 ± 29.96mg; P < 0.001) consumptions were smaller and the time to first rescue analgesia (11.7 ± 1.13 vs. 8.18 ± 1.14 h; P < 0.001) was longer in the gabapentin–celecoxib group. Conclusion The current study concluded that premedication with gabapentin 1200 mg and celecoxib 400 mg augmented the analgesic effect of tumescent anesthesia during liposuction, aided by conscious i.v. sedation/analgesia.


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