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 .
A Comparison of Gabapentin and Ketamine in Acute and Chronic Pain After Hysterectomy
BACKGROUND : Gabapentin and ketamine are popular analgesic adjuvants for improving perioperative pain management . We design ed this double-blind , placebo-controlled study to test and compare the preventive effects of perioperative ketamine and gabapentin on early and chronic pain after elective hysterectomy . METHODS : Sixty patients undergoing abdominal hysterectomy were r and omly assigned to 1 of the following 3 groups : control group received oral placebo capsules and bolus plus infusion of saline ; ketamine group received oral placebo capsules and , before incision , 0.3 mg/kg IV bolus and 0.05 mg·kg−1·h−1 infusion of ketamine until the end of surgery ; and gabapentin group received oral gabapentin 1.2 g and bolus plus infusion of saline . The anesthetic technique was st and ardized , and the postoperative assessment s included verbal rating scales for pain and sedation , IV morphine usage , quality of recovery assessment , recovery of bowel function , resumption of normal activities , and patient satisfaction with their pain management . Patients were question ed at 1 , 3 , and 6 mo after surgery for chronic postoperative pain . RESULTS : Postoperative pain scores were significantly lower in the gabapentin group compared with the ketamine and control groups , and patient-controlled analgesia morphine use was significantly reduced in both treatment groups ( versus control group ) ( P < 0.001 ) . Total patient-controlled analgesia morphine use was decreased by 35 % and 42 % in the ketamine and gabapentin groups , respectively , compared with the control group ( P < 0.001 ) . Patient satisfaction with pain treatment was significantly improved in the ketamine and gabapentin groups compared with the control group ( P < 0.001 ) . The incidence of incisional pain and related pain scores at the 1- , 3- , and 6-mo follow-up were significantly lower in the gabapentin group compared with the ketamine and control groups ( P < 0.001 ) . CONCLUSION : Gabapentin and ketamine are similar in improving early pain control and in decreasing opioid consumption ; however , gabapentin also prevented chronic pain in the first 6 postoperative months
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 .