Date of Award

2016

Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department

Physician Assistant Studies

Department Chair

John Cavenagh, MBA, PhD, PA-C

Abstract

OBJECTIVE: The objective of this selective evidence based medicine review is to determine whether or not oral gabapentin administered prior to scheduled cesarean delivery decreases pain with movement in adult women at 24 hours postpartum as compared to placebo.

STUDY DESIGN: Review of three English language, peer-reviewed, primary studies published after 2000.

DATA SOURCES: Three randomized, placebo-controlled trials comparing the efficacy of oral gabapentin to a lactose placebo in adult women undergoing elective cesarean delivery. Sources were selected from PubMed, Medline, Ovid, and the Cochrane Database to include all studies matching the keywords that were published in peer-reviewed, English language journals after 2000 and included only women over 18 years of age.

OUTCOMES MEASURED: Primary outcome measured was patient reported pain perception on a 0-100mm Visual Analog Scale (VAS - 0 = no pain, 100 = worst possible pain) measured 24 hours post cesarean section. Satisfaction with pain management, as measured by a numerical rating scale (0-10) was considered secondarily.

RESULTS: Two of the three studies found significant improvement in post-cesarean delivery analgesia and satisfaction with analgesia with adjunctive gabapentin therapy at doses of 600mg and 300mg respectively. A third study investigated both dosages, but found no clinical benefit to either.

CONCLUSIONS: Evidence is inconclusive as to whether oral gabapentin administered prior to scheduled cesarean delivery decreases pain with movement in adult women at 24 hours postpartum as compared to placebo.

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