الفهرس 
Introduction & Aim of the workOnly 14 pages are availabe for public view
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Abstract
This prospective, randomized, single-blinded study was conducted at EL-Minia university hospital, during the period from March 2017, to November 2017. The study involved 60 patients of both gender, aged between18-62 years old, and patients physical status American Society of anesthesiologists (ASA) class I and II, scheduled for lumbar laminectomy, under general anesthesia, and written informed consent from each patient was obtained.
Our objectives were to asses efficacy of post-operative analgesia and hemodynamic changes primary, financial cost, time to first analgesic request and total analgesic consumption secondary after lumbar laminectomy in the study patients.
Patients were randomly divided into two equal groups:
group (A) received 1200mg gabapentin prior to surgery 1h, and 20 ml bupivacaine 0.25% by intramuscular infiltration before closure of tissues.
group (B) received 1200mg gabapentin prior to surgery 1h, and epidural bupivacaine soaked gel foam with 20 ml of bupivacaine 0.25%
All patients were assessed with regards to:
Hemodynamics (HR, SBP, DBP, and RR) just before induction of anesthesia as a base line value, at 1h, 2h, 4h, 8, 12h, and 24h postoperative.
Pain assessment using a scoring system based on the visual analogue pain scale (VAPS) just before induction of anesthesia as a base line value, at 1h, 2h, 4h, 8, 12h, and 24h postoperative.
Sedation score using Ramsay sedation score at 1h, 2h, 4h, 8h, 12h, and 24h postoperative.
Time to first analgesic request, total analgesic consumption, and financial cost.
The incidence complication either urinary retention, nausea and vomiting, incidence of arrythmia, or pressure symptoms were recorded.
Results of this study found that demographic (age, sex, and ASA classification and operative time were statistically insignificant between both groups.
Hemodynamics (HR, SBP, DBP, and RR) were insignifically different between groups, with mild decreases in SBP and DBP in both groups at 1h, 2h post-operative. With significant reduction in group (B) at 1h postoerative.
Regarding visual aanalogue pain scor (VAPS) there was significant reduction in group (B), at 8h, 12h, and 24h postoperative.
The time to first analgesic request, total analgesic consumption no significant difference between groups,
Sedation score no difference between groups.
Financial cost was more in group (B)
Two patients in both groups have one attack of nausea and vomiting. Three patients have two attacks in group (A), while two patients in group B have two attacks, and one patient have three attacks in both groups, all treated by Ondansteron IV injection.