Pre-Operative

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PROSPECT Recommendations

  • A single dose of pre-operative oral gabapentin is recommended (GoR A) for improving postoperative pain relief (LoE 1)
  • Consensus agreement 100% (9/9)

C-Section-Specific Evidence

  • The administration of oral gabapentin 300 mg 2 h before surgery during spinal anaesthesia (without fentanyl) was superior to placebo capsule combined with fentanyl 10 µg during spinal anaesthesia for pain relief and time to first analgesic request Najafi Anaraki and Mirzaei 2014
  • A single pre-operative dose of oral gabapentin 600 mg compared to placebo reduced post-caesarean pain and increased maternal satisfaction Moore et al 2011
  • A single pre-operative dose of either 300 mg or 600 mg oral gabapentin did not improve post-caesarean pain management and maternal satisfaction (Study was underpowered) Short et al 2012
  • Gabapentin study details Click here for more information

PROSPECT Recommendations

  • Pre-operative dexamethasone cannot be recommended at this time (GoR D) based on limited procedure-specific evidence
  • Consensus agreement 100% (9/9)

C-Section-Specific Evidence

  • Dexamethasone 10 mg given intravenously before surgery decreased postoperative pain with movement at 1 h, 6 h, 12 h and 24 h, but not at 2 h and 3 h, compared with placebo. Although the cumulative incidence of PONV was significantly lower in women receiving dexamethasone, there were no significant differences in PONV at specific assessment time points Cardoso et al 2013
  • Intravenous dexamethasone 8 mg administered before skin incision was superior to placebo in pain scores at rest and on movement between 6 and 24 h, but not before. However, there was no significant difference in the consumption of supplemental analgesia Wu et al 2007
  • Dexamethasone study details Click here for more information