Gabapentin is an anticonvulsant that has become a treatment option for several indications that are not approved by Health Canada. Commonly, gabapentin is prescribed for neuropathic pain and anxiety disorders. The objective of this dissertation was to evaluate the efficacy of gabapentin for reducing pre-operative anxiety, post-operative pain and opioid consumption. The initial study examined regimens of pre-operative and post-operative gabapentin given to patients undergoing total knee arthroplasty. Patients that received gabapentin postoperatively used significantly less morphine at 24 hrs, 36 hrs and 48 hrs (p<0.05). Furthermore these patients had significantly better active-assisted knee flexion on postoperative day (POD) 2, POD 3, with a trend toward better flexion on POD 4. Next, we examined whether: 1) gabapentin administration reduces pain and opioid use after total hip arthroplasty using a multimodal analgesic regimen that included spinal anesthesia; and whether 2) preoperative administration of gabapentin is more effective than postoperative administration. Our results demonstrated that whether a 600 mg dose of gabapentin was given preoperatively or postoperatively, patients’ postoperative morphine consumption or pain scores were not reduced in hospital nor was there a reduction in pain 6 months after hip arthroplasty. The third study found that a single dose of 600 mg of gabapentin was not sufficient to reduce preoperative anxiety in patients prior to hip arthroplasty. In contrast, the final study demonstrated that 1200mg of gabapentin reduced pre-operative anxiety and pain catastrophizing in female patients with moderate to high levels of preoperative anxiety prior to major surgery, but also increased preoperative and early postoperative sedation. Our findings demonstrate the efficacy of perioperative gabapentin with respect to preoperative anxiety reduction and decreasing morphine consumption after surgery. Future studies that focus on the optimal dose and duration of perioperative gabapentin, with the aim of improving functional outcomes and decreasing the incidence and severity chronic post-surgical pain are warranted.

Dissertation (Ph.D.)--University of South Florida, 2007. / Title from PDF of title page. Document formatted into pages; contains 107 pages. Includes vita. Includes bibliographical references.

Diss. (sammanfattning) Stockholm : Karol. inst., 2002. / Härtill 5 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst., 2003. / Härtill 4 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst., 2006. / Härtill 4 uppsatser.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2006. / Härtill 4 uppsatser.

Thesis (M.S.)--University of Michigan, 1982.

Thesis (M.S.)--University of Michigan, 1988.

Thesis (M.S.)--University of Michigan, 1988.

Bakgrund: Vårdrelaterade infektioner är vanliga och leder till långa vårdtider, lidande för patienterna och höga kostnader för sjukvården. Målet med den preoperativa duschen med klorhexidintvål, byte av kläder och sänglakan efter duschen är att minska de negativa konsekvenserna. Det blir vanligare att preoperativa förberedelser görs i det egna hemmet eller på patienthotell, som en slags egenvård, för att sedan läggas in på preoperativ avdelning för resterande preoperativa förberedelser. För att detta ska lyckas krävs det relevant information från vårdpersonal och sjuksköterskorna har ett stort ansvar och plikt att förse patienterna med nödvändig information. Syfte: Att belysa hur patienter upplevde informationen om och genomförandet av preoperativa förberedelser i hemmet eller på patienthotell. Metod: En empirisk kvalitativ intervjustudie med semistrukturerade intervjuer. Materialet analyserades enligt Granheim och Lundmans beskrivning av innehållsanalys på manifest nivå. Urvalet genomfördes ändamålsenligt. Deltagarna i studien bestod av 13 patienter från en preoperativ avdelning i Mellansverige. Resultat: Deltagarna var övergripande nöjda med den preoperativa informationen och att utföra förberedelserna i hemmet eller på patienthotell. Individuella faktorer påverkade upplevelserna av den preoperativa informationen och beroende på individens förutsättningar varierade upplevelserna av de preoperativa förberedelser i hemmet eller på patienthotellet. Slutsats: Större delen av patienterna upplevde att den preoperativa informationen och att utföra de preoperativa förberedelserna i hemmet eller på patienthotell var positivt. Vissa faktorer gjorde upplevelserna negativa, dessa faktorer var individuella. Resultatet anses skapa större patientförståelse och belyser positiva och negativa delar av den preoperativa vården. / Background: Nosocomial infections are common and lead to long hospital stays and suffering for patients beside high costs for hospitals. The aim of preoperative shower with chlorhexidine soap, change of clothes and bed sheets after the shower is to reduce this. It is common that patients conduct the preoperative preparations in their own home or at a patient hotel, as a kind of self-care, then they are admitted to the preoperative ward for the remaining preoperative preparations. For the self-care to succeed they need relevant information from health professionals and nurses have a responsibility and duty to provide patients with necessary information. Aim: The aim of the study was to highlight patients' experiences about the preoperative information and the implementation of the preoperative preparations in their own home or at a patient hotel. Method: An empirical qualitative study with semi-structured interviews. The material was analysed according to Graneheim and Lundman's qualitative manifest content analysis. Patients were included through a purposive sampling and 13 patients from a preoperative ward in central Sweden participated in the study. Results: The participants were overall satisfied with the preoperative information and carrying out the preparations at home or in a patient hotel. Individual factors affected the experience of the preoperative information and due to individual circumstances the experiences of preoperative preparation at home or at a patient hotel varied. Conclusion: Most of the patients felt that the preoperative information and the implementation of the preoperative preparation at home or in a patient hotel were positive. Certain factors were experienced negative, these factors were individual. Based on the results of this study greater patient understanding is created and it highlights the positive and negative elements in the preoperative self-care.