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Comparison of Analgesic Effect between Gabapentin and Diclofenac on Post-Operative Pain in Patients Undergoing Tonsillectomy – is the evidence enough?


1 Department of Obstetrics and Gynecology ,University of Federal do Rio Grande do Sul, Porto Alegre, Brazil
*Corresponding author: Ricardo Savaris, Ricardo Savaris, Department of Obstetrics and Gynecology, University of Federal do Rio Grande do Sul, Porto Alegre, Brazil. Tel.: +55-5133598693, Fax: +55-5133598117, E-mail: rsavaris@hcpa.ufrgs.br.
Archives of Trauma Research. 2013 February; 1(4): 191-191. , DOI: 10.5812/atr.9879
Article Type: Letter; Received: Dec 20, 2012; Revised: Dec 23, 2012; Accepted: Dec 23, 2012; epub: Feb 1, 2013; ppub: Feb 1, 2013
Running Title: When Consort is Needed

Keywords: Gabapentin; Diclofenac; Tonsil

Dear Editor,


I read with great interest the work published by Mogadam et al., entitled "Comparison of Analgesic Effect between Gabapentin and Diclofenac on Post-Operative Pain in Patients Undergoing Tonsillectomy" (1). I found the article quite interesting, however I have few questions that should be answered before we start to prescribe gabapentin or diclofenac to all patients before tonsillectomy, with the given data on pain score (Table 2), assuming that each group had an n = 30, I was not able to reproduce the significant difference among the subjects on pain scores after surgery. Calculation was done using one-way ANOVA, hence they presented their data as mean ± standard deviation. Furthermore, I believe that their results would be more meaningfull if they followed the CONSORT guidelines (2, 3). For instance, the placebo group did not receive any capsule or suppository to make the placebo effect. The authors informed that they used oral and rectal vias, and the placebo group did not receive any medication. Hence, patients were aware of what they were receiving, making the study not double-blind. Interesting enough, pain scores after surgery were the same among groups, but the placebo used a higher amount of meperidine. This could be explained the fact that the subjects were aware that they did not receive any medication for pain. Secondly, although all groups received intramuscular meperidine as needed, this drug should not be used as a pain killer. Meperidine has an erratic distribution, and its benefit as an analgesic has been questioned for long (4). Therefore, despite the interesting study undertaken by Mogadam et al. it seems that more research should be done on this subject.

Footnotes

Please cite this paper as: Savaris R. Comparison of Analgesic Effect between Gabapentin and Diclofenac on Post-Operative Pain in Patients Undergoing Tonsillectomy. Arch Trauma Res. 2013;1(4): 191. DOI:10.5812/atr.9879
Authors’ Contribution: The author has conducted the whole manuscript.
Financial Disclosure: There is no financial disclosure.

References


  • 1. Yeganeh Mogadam A, Fazel M, Parviz S. Comparison of Analgesic Effect between Gabapentin and Diclofenac on Post-Operative Pain in Patients Undergoing Tonsillectomy. Arch Trauma Res. 2012;1(3):108-11.
  • 2. Altman DG, Moher D, Schulz KF. Improving the reporting of randomised trials: the CONSORT Statement and beyond. Stat Med. 2012;31(25):2985-97. [DOI] [PubMed]
  • 3. Consort 2010. Lancet. 2010;375(9721):1136. [DOI] [PubMed]
  • 4. Latta KS, Ginsberg B, Barkin RL. Meperidine: a critical review. Am J Ther. 2002;9(1):53-68. [PubMed]