• Eduardo Jun Sadatsune, Plínio da Cunha Leal, Rachel Jorge Dino Cossetti, and Rioko Kimiko Sakata.
• MD, MSc. Anesthesist, Department of Surgery, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brazil.
• Sao Paulo Med J. 2016 Jul 1; 134 (4): 285291285-91.

Context And ObjectivesEffective postoperative analgesia is important for reducing the incidence of chronic pain. This study evaluated the effect of preoperative gabapentin on postoperative analgesia and the incidence of chronic pain among patients undergoing carpal tunnel syndrome surgical treatment.Design And SettingsRandomized, double-blind controlled trial, Federal University of São Paulo Pain Clinic.MethodsForty patients aged 18 years or over were randomized into two groups: Gabapentin Group received 600 mg of gabapentin preoperatively, one hour prior to surgery, and Control Group received placebo. All the patients received intravenous regional anesthesia comprising 1% lidocaine. Midazolam was used for sedation if needed. Paracetamol was administered for postoperative analgesia as needed. Codeine was used additionally if the paracetamol was insufficient. The following were evaluated: postoperative pain intensity (over a six-month period), incidence of postoperative neuropathic pain (over a six-month period), need for intraoperative sedation, and use of postoperative paracetamol and codeine. The presence of neuropathic pain was established using the DN4 (Douleur Neuropathique 4) questionnaire. Complex regional pain syndrome was diagnosed using the Budapest questionnaire.ResultsNo differences in the need for sedation, control over postoperative pain or incidence of chronic pain syndromes (neuropathic or complex regional pain syndrome) were observed. No differences in postoperative paracetamol and codeine consumption were observed.ConclusionsPreoperative gabapentin (600 mg) did not improve postoperative pain control, and did not reduce the incidence of chronic pain among patients undergoing carpal tunnel syndrome surgery.

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