Preoperative Analgesia in Non-gynecological Cancerous Women Who Underwent Elective Total Abdominal Hysterectomy

Total abdominal hysterectomy (TAH) is the most common gynecological operation worldwide.Some studies noticed about overused of opioids in postoperative care , leaded to more adverse effect of opioids , slowly recovery , prolong length of hospitalized stay and consequently increase unnecessary cost of treatment.

ERAS guidelines has considered to use preoperative analgesics for reducing post-operative opioids consumption, including Gabapentin and Celecoxib.

Gabapentin and celecoxib widely used for treatment of pain and many studies have demonstrated the preoperative efficacy and safety of Gabapentin and Celecoxib in variety procedures involving hysterectomy.However, no definite conclusion of optimal dose and timing for preopearive uptake ,apart from no good evidences based supported preoperative Gabapentin or Celecoxib in hysterectomy in Thailand . In addition, the protocol for preoperative analgesics in hysterectomy, has not been performed in the investigator's center.

Therefore the aim of this study is to assess and compare the efficacy and safety of preoperative Gabapentin and Celecoxib to reduce acute postoperative pain in non-gynecological cancerous woman undergoing total abdominal hysterectomy

Inclusion criteria

• Women ranging age between 18-65 years and having non-gynecological cancerous women who undergoing elective total abdominal hysterectomy
• Women who has ASA physical status I-II
• Women who agrees to participate in this study

Exclusion criteria

• Women who pregnancy
• Women who have abnormal kidney function test (Cr > 1.5 )
• Women who have abnormal liver function test
• Women with history or present of thrombosis such as myocardial infarction, ischemic stroke, deep venous thrombosis or pulmonic embolism
• Women with history of gastrointestinal bleeding -Women with history of gastrointestinal bleeding -Women with history of gastrointestinal bleeding
• Women who take the antiplatelet or anticoagulant medications
• Women with history of allergy to Gabapentin ,Celecoxib and Sulfa
• Women who have used or known Gabapentin or Celecoxib before
• Women who have chronic alcoholism
• Women who underwent previous surgery
• Women who undergo extended low midline incision
• Women who undergo lysis adhesion
• Women who undergo further operations except salpingo-oophorectomy
• Women who cannot evaluated pain score