P-173IMPACT OF PERIOPERATIVE GABAPENTIN ADMINISTRATION ON POSTOPERATIVE OPIOID REQUIREMENTS AND CHRONIC PAIN IN PATIENTS UNDERGOING ANATOMICAL LUNG RESECTIONS FOR NON-SMALL CELL LUNG CANCER

Abstract

Objectives: Postoperative and chronic pain have a major impact on patient recovery after anatomical lung resections for non‐small cell lung cancer (NSCLC). This study aimed to evaluate the impact of perioperative gabapentin in reducing postoperative opioid requirements and pain at 2 weeks. Methods: Between August and December 2015, 62 consecutive patients undergoing video‐assisted (VATS) or open anatomical lung resections for NSCLC were prospectively included and divided into two groups: (1) Gabapentin plus standard analgesia (G + SA) (morphine/fentanyl PCA, morphine/dihydrocodeine, paracetamol and ibuprofen): 600 mg of gabapentin immediately preoperatively and for 1 week postoperatively (300 mg three times daily); (2) standard analgesia (SA) only. A validated pain score, the brief pain inventory (BPI) created by Dr Cleeland, was used to assess pain in the immediate postoperative period and at two weeks after surgery. Results: Sixty‐two consecutive patients with a median age of 71 years were included: 27 patients in G + SA group (VATS n = 15, open n = 12); 35 patients in SA group (VATS n = 25, open n = 10). No significant differences in demographics were observed between the 2 groups. One patient stopped gabapentin due to excessive sedation. Duration of PCA use and pain scores at 8 h, 24 h and 48 h postoperatively were not significantly different between the two groups. Patients undergoing VATS resection required less PCA morphine in the G + SA group than those in the SA group (21 vs 37 mg respectively; P = 0.04), and had their PCA removed earlier (1.2 vs 1.5 days respectively; P = 0.03). Patients undergoing VATS in the G + SAP group had reduced pain scores 2‐weeks postoperatively compared to SAP patients (P = 0.01). Subsequently, fewer VATS patients in the G + SAP group required opioids 2‐weeks postoperatively, compared to the SAP group (41% vs 58% respectively; P = ns). Conclusion: Gabapentin is a safe and effective analgesic in reducing postoperative morphine requirements and pain at two week evaluation post surgery.