Gabapentin offers pain relief during second-trimester surgical abortion

Preoperative administration of gabapentin helps reduce intraoperative pain in women undergoing second-trimester surgical abortion, leading to improved satisfaction with pain management, as shown in a randomized, controlled, double-blind trial.

The study included 126 patients undergoing same-day dilation and evacuation (D&E) under moderate sedation D&E at 14–19 weeks of gestation. They were randomized to receive gabapentin 600 mg (n=61) or placebo (n=65) after cervical preparation at least one hour prior to D&E.

Researchers evaluated pain using a 100-mm visual analogue scale before, during, and after the procedure. They measured satisfaction with pain control, nausea, and vomiting by using Likert scales, as well as anxiety using a validated instrument.

Gabapentin was administered a mean of 211 minutes before D&E. The primary endpoint of postoperative recall of maximum procedural pain did not significantly differ between the gabapentin and placebo groups (41 vs 49 mm; p=0.24). However, gabapentin was associated with reduced pain during uterine aspiration (56 vs 71 mm; p=0.003), but not for any other time points.

More women in the gabapentin than in the placebo group had higher satisfaction with their treatment (78 percent vs 65 percent reported being very or somewhat satisfied; p=0.01).

Median fentanyl dose was markedly lower in the gabapentin group (75 vs 100 mcg; p=0.005). Meanwhile, midazolam dose, nausea, vomiting, and anxiety were all similar in the two groups.

None of the women in the gabapentin group experienced serious adverse events. Sedation reversal was not required.

The findings indicate that gabapentin may be considered as an adjunct to intravenous sedation for pain management during D&E.