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 .
Gabapentin Improves Postcesarean Delivery Pain Management: A Randomized, Placebo-Controlled Trial
BACKGROUND : Gabapentin is effective for preventing and treating acute and chronic postoperative pain ; however , it has not been described for use in cesarean delivery . We hypothesized that preoperative gabapentin would reduce  postcesarean delivery pain . METHODS : Women undergoing scheduled cesarean delivery were r and omized to receive preoperative gabapentin 600 mg , or placebo . Spinal anesthesia was achieved with 0.75 % hyperbaric bupivacaine 12 mg , fentanyl 10 & mgr;g , and morphine 100 & mgr;g . Postoperative analgesia was initiated with intraoperative ketorolac and acetaminophen , and continued with postoperative diclofenac , acetaminophen , and morphine . Patients were assessed at 6 , 12 , 24 , and 48 hours after spinal anesthesia for pain at rest and on movement using a visual analog scale ( 0 to 100 mm ) , satisfaction , opioid consumption , and side effects . Neonatal interventions , Apgar scores , umbilical artery blood gases , and breastfeeding difficulties were assessed . Chronic pain was assessed 3 months after delivery . Maternal and umbilical vein gabapentin plasma concentrations were measured in a subgroup of patients . Mixed-model analysis was used to compare the primary outcome of visual analog scale pain scores at 24 hours between groups . RESULTS : Forty-six patients were r and omized , and 2 were excluded from analysis . The mean ( 95 % confidence interval , CI ) pain scores on movement at 24 hours were 21 mm ( CI = 13–28 ) in the gabapentin and 41 mm ( CI = 31–50 ) in the placebo group ( P = 0.001 ) . Maternal satisfaction was higher in the gabapentin group . There was no difference in opioid consumption . Severe maternal sedation was more common in the gabapentin group ( 19 % vs. 0 % , P = 0.04 ) . There was no difference in neonatal Apgar scores , interventions , or umbilical artery pH. The mean ( SD ) maternal vein : umbilical vein plasma gabapentin ratio was 0.86 ( 0.12 ) . The incidence of pain at 3 months was similar in both groups . CONCLUSION : Preoperative gabapentin 600 mg in the setting of multimodal analgesia reduces postcesarean delivery pain and increases maternal satisfaction in comparison with placebo
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 .