Multimodal analgesia with gabapentin, ketamine and dexamethasone in combination with paracetamol and ketorolac after hip arthroplasty: a preliminary study

A Special Authors Introduction

By Ole Mathiesen 

The combination of different analgesics offers potential advantages in postoperative pain treatment compared to single modality treatment alone. However, only a limited number of studies have examined the postoperative analgesic effect of combinations of more than two or three drugs. The investigation on procedure-specific optimal combinations and doses of different analgesics is time consuming and costly which may offer an explanation on this matter. Nevertheless, the concept of multimodal postoperative analgesia continues to represent an important area of research that may promote recovery and ambulation of the patients.

Gabapentin, ketamine and dexamethasone have demonstrated analgesic effects in a number of trials and offer not only improved pain treatment but also advantages like reduced postoperative nausea and vomiting and/or reduced postoperative fatigue.
In this preliminary study we have described the analgesic effect of the combination of these three drugs on top of a basic analgesic regimen of paracetamol and ketorolac.

Although total hip arthroplasty may be followed by only low to moderate pain scores and although the basic analgesic regimen was an effective pain treatment for the patients in this present study, the combination of all 5 different analgesics demonstrated superior analgesic efficacy compared to the basic pain treatment alone.

Another significant result from this preliminary study was that this combination of drugs almost eliminated the number of patients with excessive pain, offering a potential important subject for future investigation.

This Article was published in European Journal of Anaesthesiology
The full article is available to registered users. Please sign in at top of page, click here to go to the registered users' area or register.