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1 : * 1 (MSc) - (MD) (MD) - (MD) * : K_haryalchi@yahoo.com: 93/07/20 : 93/03/10:. :.. : : mg 300 mg.. (NRS) /94±0/68 4/10±0/84 12 : 3/44±0/79 3/50±0/86 24.(P=0/228) 24.(P=1/0).(P=0/593). (P=0/487) (P=1/0) (P=0/241). : IRCT N2 : / / / / : : 93..(4 3).(3) 5) :.(6..(2 1).(2).1 63

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3 ... 0/5 mg/kg. (NRS) SPSS 21.. (p-value). 0/ (P=0/971).(P=0/05). 95 (16) ) (Block Randomization). ( mg mg cc mg/kg 1 µg/kg. 1 mg/kg 0/5 mg/kg 50 N2O. 1 RR12/min 6-8 ml/kg mg/kg.. 0/02 mg/kg 0/ /93 / / 65

4 - - (%26) 13. (%28) 14 (%8) 4 (%4) 2..(P=0/179) (%66) 33.(1 ) (P=0/507) (%68) /971 0/416 0/952 0/247 0/179 0/507 (50=) ± 46/42 ±5/60 4/88 ±0/85 4/76 ±0/69 4/64 ±0/63 3/47 ±1/41 0/34 ±0/56 24.(P=1/0) (P=0/241) (P=0/487) (P=1/0).(2 ) (50=) ± 46/46 ±5/57 5/10 ±1/05 4/88 ±1/0 4/72 ±0/70 2/82 ±1/24 0/42 ±0/ (P=0/228) 24.(P=0/593) 1392 :2 P value 0/228 0/593 0/241 1/0 0/487 (50=) 3/94 ±0/68 3/44 ±0/79 9 (18) 8 (16) 6 (12) (50=) 4/10 ±0/84 3/50 ±0/86 15 (30) 8 (16) 3 (6) ( ±) ().(26-15).(27) /93 / /

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6 Berek J. Berek. Novak s Gunecology. 14th Edition. Philadelphia; Lippincott Williams & wilkins, 2007: Brandsborg B. Pain following hysterectomy: Epidemiological and clinical aspects. Dan Med J 2012;59(1 ): B Abram Stephen E. The pain clinic manual. 2nd edition.philadelphia; Lippincott Williams & Wilkins, 2000: Basbaun AI. Distinct neurochemical features of acute and persistent pain. Proc Natl Acad Sci USA 1999; 96(14); Torda T A. Postoperative analgesia. Aust Prescr 1995;18: Kehlet H, Holte K. Effect of postoperative analgesia on surgical outcome. Br J Anaesth 2001;87: Liu SS, Wu CL. Effect of postoperative analgesia on major postoperative complications: a systematic update of the evidence. Anesth Analg 2007; 104: Stanley G, Appadu B, Mead M, Rowbotham DJ. Dose requirements, efficacy and side effects of morphine and pethidine delivered by patient-controlled analgesia after gynaecological surgery. Br J Anaesth 1996;76: Buvanen dran A, Krion JS. Useful/ adjuavant for post operative pain management. Best pract Resclin Anaesthejol 2007; 27(1): Romsing J, Moiniche S. A systematic review of COX-2 inhibitors compared with traditional NSAIDs, or different COX-2 inhibitors for post-operative pain. Acta Anaesthesiol Scand 2004;48(5): Barden J, Edwards J, Moore RA, McQuay HJ. Single dose oral diclofenac for postoperative pain. Cochrane Database Syst Rev 2004; 2: CD Cheng JK, Chiou LC. Mechanisms of the antinociceptive action of gabapentin. J Pharmacol Sci 2006; 100: Dahl JB, Mathiesen O, Moiniche S. Protective premedication : an option with gabapentin and related drugs? A review of gabapentin and pregabalin in in the treatment of post-operative pain. Acta Anaesthesiol Scand 2004;48(9 ): Backonja M BAEKR, et al. Gabapentin for the symptomatic treatment of painful neuropathy in patients with diabetes mellitus: A randomized controlled trial. JAMA 1998;280(21): Turan A, Karamanlıog lu B, Memis D, Usar P, Pamukc u Z, Tu re M. The Analgesic Effects of Gabapentin After Total Abdominal Hysterectomy. Anesth Analg 2004;98: Sekhavat L, Zare F, Mojibian M. The Post Operative analgesic effects of low dose Gabapentin in patients undergoing Abdominal Hysterectomy. SAJOG 2009; 15(1 ): Ziba Zahiri Soroori, Seyedeh Hajar Sharami, Abtin Heidarzade. The comparsion between suppository diclofenac and pethidin in post-cesarean section pain relief. Journal of Research in Medical Sciences 2006; 11(5): Turan A, Kayu G; Karman Liylu B, Pamukcu Z C. Effect of oral gabapentin on postoperative epidural analysia British.Journal of Anasthesia 2005; 96(2): Mansour ghanaei M, Mirblook F, Boini S, Erfani Sayyar R, Shakiba M, Naghdi Pour M, Rahmani S. The Analgesic Effects of Gabapentin after Total Abdominal Hysterectomy. The Iranian Journal of Obstetrics, Gynecology and Infertility 2012; 15 (1): Durmas M, Akadir ButA, Sari CickV. The post operative analgesic effect of a combination of gabapentin and paractomal in patients undergoing abdominal Hysterectomy = a randomized clinical trial Acta Anthesivl Scand 2007; 57: Alparslan T, Karamun Liylu B, Hamamcioylu MK, Tukenmez B, pamukeu Z, kurt A. Analgsic Effect of Gabapentin after spinal surgery. Anthesiology 2004; 100: Alpharslan T, Delik memis B, Usar P, Pamak cu Z, Ture M. The Analgesic Effect of Gabapentin after toral Abdominal Hysterectomy.Anestl Analy 2004; 98: Panah Khahi M, Marashish SH, Khajavi MR, Najafi A, Yaghooti A, Iamani F. Post operative Gabapentin to Randomized clinical Trial. Anesth pain 2012; 2(2): Biyik I, Gülcüler M, Karabiga M, Ergene O, Tayyar N. Efficacy of gabapentin versus diclofenac in the treatment of chest pain and paresthesia in patients with sternotomy. Anadolu Kardiyol Derg 2009; 9(5): Ucak A, Onan B, Sen H, Selcuk l, Turan A, Yilmaz.The Effects of Gabapentin on Acute and Chronic Postoperative Pain After Coronary Artery Bypass Graft Surgery. Journal of Cardiothoracic and Vascular Anesthesia 2011; 25( 5): Gilron I, Orr E, Tu D, O Neill JP, Zamora JE, Bell AC. A placebo-controlled randomized clinical trial of perioperative administration of gabapentin, rofecoxib and their combination for spontaneous and movementevoked pain after abdominal hysterectomy. Pain. 2005; 113(1-2): Tiippana EM, Hamunen K, Kontinen VK, Kalso E. Do surgical patients benefit from perioperative gabapentin/pregabalin? A systematic review of efficacy and safety. Anesth Analg 2007;104(6): /93 / /

7 ... Comparison of Low Dose Gabapentin and Diclofenac Efficacy for Postoperative Pain Reduction after Abdominal Hysterectomy: a Randomized Clinical Trial Faraji R(MD) 1 - * Haryalchi K(MD) 1 - Fashkhami F(MD) 1 - Pourmarzi D(MSc) 1 *Corresponding Address: Reproductive Health Research Center, Alzahra Hospital, Guilan University of Medical Sciences, Rasht, Iran K_haryalchi@yahoo.com Received: 31/ May/2014 Abstract Accepted : 12/ Oct/2014 Introduction: Diclofenac is one of common non-steroidal anti-inflammatory drug that is used for postoperative pain relief. There are some limitations to diclofenac usage. Finding alternative methods that are safe and effective is very important. Gabapantin is one of cheap, available, and low side effects in low dose drug that is considered as postoperative pain relief supplement. Objective: This study aimed to comparison of effect of low dose gabapentin and diclofenac for postoperative pain reduction after abdominal hysterectomy. Materials and Methods: A double blinded randomized trial conducted on 100 undergoing hysterectomy patients in Alzahra hospital from 2013 to Patients were randomly assigned in two equal number groups. Patients in one of group received 300 mg gabapentin orally and placebo rectally patients in other group received placebo orally and 100 mg diclofenac rectally in 8 and 16 hours after hysterectomy. Pain was assessed using numeric rating scale (NRS) in 12 and 24 hours after surgery. Pethedine consumption and adverse effects over 24 hours after surgery were recorded. Results: Mean of pain score in 12 hours after surgery were 4.10 ± 0.84 in gabapentin group and 3.94 ± 0.68 in declofenac group that this difference between two group was not significant (P = 0.228). Mean of pain score in 24 hours after surgery were 3.50 ± 0.86 and 3.44 ± 0.79 in gabapentin and declofenac groups, respectively, that this difference was not significant (P = 0.593). Only one patient in diclofenac group requested pethedine after intervention (P = 1.0). Over 24 hours after surgery there were no significant difference between two groups in term of incidence of nausea (P=0.241), vomiting (P = 1.0) and dizziness (P = 0.487). Conclusion: Based on result of this study gabapentin is as effective as declofenac on pain reduction after hysterectomy that can be a suitable replacement for diclofenac. Trial registration Number: IRCT N2 Conflict of interest: non declared Keywords: Anethesia, General /Diclofenac/ Gabapentin/ Hysterectomy/ pain Journal of Guilan University of Medical Sciences, No: 93, Pages: Please cite this article as: Faraji R, Haryalchi K, Fashkhami F, Pourmarzi D. Comparison of Low Dose Gabapentin and Diclofenac Efficacy for Postoperative Pain Reduction after Abdominal Hysterectomy: a Randomized Clinical Trial. J of Guilan University of Med Sci 2015; 24(93): [Text in Persian] 1. Reproductive Health Research Center, Alzahra 1394 Hospital, Guilan /93 University / of Medical / Sciences, Rasht, Iran 69