Gabapentin reduces preoperative anxiety and pain catastrophizing in highly anxious patients prior to major surgery: a bl
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REPORTS OF ORIGINAL INVESTIGATIONS
Gabapentin reduces preoperative anxiety and pain catastrophizing in highly anxious patients prior to major surgery: a blinded randomized placebo-controlled trial La gabapentine re´duit l’anxie´te´ pre´ope´ratoire et la catastrophisation de la douleur chez les patients tre`s anxieux avant une chirurgie majeure: une e´tude randomise´e controˆle´e par placebo et en aveugle Hance Clarke, MD • Kyle R. Kirkham, MD • Beverley A. Orser, MD, PhD Rita Katznelson, MD • Nicholas Mitsakakis, PhD • Raynauld Ko, MD • Adam Snyman, MD • Martin Ma, MD • Joel Katz, PhD
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Received: 25 September 2012 / Accepted: 14 January 2013 / Published online: 2 February 2013 Ó Canadian Anesthesiologists’ Society 2013
Abstract Introduction Gabapentin is increasingly being used for the treatment of postoperative pain and a variety of psychiatric diseases, including chronic anxiety disorders. Trials have reported mixed results when gabapentin has been administered for the treatment of preoperative anxiety. We tested the hypothesis that gabapentin 1,200 mg vs Author contributions Hance Clarke is the primary author of this manuscript. He is responsible for designing the study and reviewing the analysis of the data. Joel Katz is the senior author. Kyle Kirkham is a co-author of the manuscript. Kyle Kirkham, Raynauld Ko, and Joel Katz helped design the study. Kyle Kirkham and Joel Katz helped review the analysis of the data. Kyle Kirkham, Beverley Orser, Rita Katznelson, Adam Snyman, Raynauld Ko, Martin Ma, and Joel Katz contributed to the writing of the manuscript. Beverley Orser helped to develop the initial protocol. Nicholas Mitsakakis is the biostatistician responsible for the analysis of the data. H. Clarke, MD (&) K. R. Kirkham, MD R. Katznelson, MD N. Mitsakakis, PhD R. Ko, MD A. Snyman, MD M. Ma, MD J. Katz, PhD Department of Anesthesia and Pain Management, Toronto General Hospital, 200 Elizabeth Street, Eaton North 3 EB 317, Acute Pain Research Unit, Toronto, ON M5G 2C4, Canada e-mail: [email protected] H. Clarke, MD B. A. Orser, MD, PhD Department of Anesthesiology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada H. Clarke, MD K. R. Kirkham, MD B. A. Orser, MD, PhD R. Katznelson, MD R. Ko, MD A. Snyman, MD M. Ma, MD J. Katz, PhD Department of Anesthesia, University of Toronto, Toronto, ON, Canada
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placebo would reduce preoperative anxiety in patients who exhibit moderate to high preoperative anxiety. Methods A blinded randomized controlled trial was conducted from September 2009 to June 2011 at the Toronto General Hospital. Following ethics approval and informed consent, 50 female patients with a 0-10 numeric rating scale (NRS) anxiety score of greater than or equal to 5/10 consented to receive either gabapentin 1,200 mg (n = 25) or placebo (n = 25) prior to surgery. Randomization was computer generated, and the Investigational Pharmacy was responsible for the blinding and dispensing of medication. All patients and care providers, including physicians, nurses
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