Such interventions would have the potential to reduce the prevalence of chronic pain in the population .
Although certain risk factors can identify individuals who are most likely to develop chronic pain , few interventions to prevent chronic pain have been identified .
To facilitate the identification of preventive interventions , an IMMPACT meeting was convened to discuss research design considerations for clinical trials investigating the prevention of chronic pain .
We present general design considerations for prevention trials in population s that are at relatively high risk for developing chronic pain .
Preoperative gabapentin for acute post-thoracotomy analgesia: a randomized, double-blinded, active placebo-controlled study.
BACKGROUND The role of preoperative gabapentin in postoperative pain management is not clear , particularly in patients receiving regional blockade . Patients undergoing thoracotomy benefit from epidural analgesia but still may experience significant postoperative pain . We examined the effect of preoperative gabapentin in thoracotomy patients . METHODS Adults undergoing elective thoracotomy were enrolled in this prospect i ve , r and omized , double-blinded , placebo-controlled study , and r and omly assigned to receive 600 mg gabapentin or active placebo ( 12.5 mg diphenhydramine ) orally within 2 hours preoperatively . St and ardized management included thoracic epidural infusion , intravenous patient-controlled opioid analgesia , acetaminophen and ketorolac .  Pain scores , opioid use and side effects were recorded for 48 hours . Pain was also assessed at 3 months . RESULTS One hundred twenty patients ( 63 placebo and 57 gabapentin ) were studied .  Pain scores did not significantly differ at any time point ( P = 0.53 ) . Parenteral and oral opioid consumption was not significantly different between groups on postoperative day 1 or 2 ( P > 0.05 in both cases ) . The frequency of side effects such as nausea and vomiting or respiratory depression was not significantly different between groups , but gabapentin was associated with decreased frequency of pruritus requiring nalbuphine ( 14 % gabapentin vs. 43 % control group , P < 0.001 ) . The frequency of patients experiencing pain at 3 months post-thoracotomy was also comparable between groups ( 70 % gabapentin vs. 66 % placebo group , P = 0.72 ) . CONCLUSIONS A single preoperative oral dose of gabapentin ( 600 mg ) did not reduce pain scores or opioid consumption following elective thoracotomy , and did not confer any analgesic benefit in the setting of effective multimodal analgesia that included thoracic epidural infusion
Such interventions would have the potential to reduce the prevalence of chronic pain in the population .
Although certain risk factors can identify individuals who are most likely to develop chronic pain , few interventions to prevent chronic pain have been identified .
To facilitate the identification of preventive interventions , an IMMPACT meeting was convened to discuss research design considerations for clinical trials investigating the prevention of chronic pain .
We present general design considerations for prevention trials in population s that are at relatively high risk for developing chronic pain .