Study Investigates Baclofen premedication for Postoperative Pain Control

Baclofen, a drug that activates the GABAB receptor, has been shown to provide pain relief without the use of opioids in various pain models. However, there have been few studies investigating its effectiveness in controlling pain during the perioperative period. Recent research paper examines the effects of baclofen, a GABA B receptor agonist, on postoperative pain measures and opioid use in adult patients who underwent percutaneous nephrolithotomy (PCNL) procedures. The study was a placebo-controlled, double-blind randomized trial conducted at the University of Alabama at Birmingham.

A total of 34 patients undergoing PCNL were randomly assigned to receive either a single 10 mg oral dose of baclofen or a placebo prior to surgery. Standardized intraoperative and postoperative protocols were followed, and the use of postoperative opioids, pain scores, vital signs, and other medication use were recorded. The results showed that there was no significant difference in opioid use or pain scores between the baclofen and placebo groups. However, when patients were stratified based on their preoperative opioid use, there was a significant positive correlation between preoperative opioid use and postoperative opioid consumption. Importantly, there were no significant differences in vital signs, side effects, or other medication use between the two groups.

Conclusions and Recommendations

The authors conclude that the analgesic benefits of preoperative baclofen were not observed at the 10 mg dose used in this study. They suggest that higher doses or repeated dosing of baclofen may be needed to observe potential analgesic effects, though they caution that higher doses have been associated with postoperative delirium and other side effects. The authors also note that the surgical procedure chosen (PCNL) may not have been an optimal choice for studying the analgesic effects of baclofen. Overall, the study found that a single preoperative dose of baclofen did not provide significant analgesic benefits in patients undergoing PCNL, but the safety of the drug was observed.

Key Points

The key points of the research paper are: 1. The study examined the effects of baclofen, a GABA B receptor agonist, on postoperative pain measures and opioid use in adult patients who underwent percutaneous nephrolithotomy (PCNL) procedures. 2. The study was a placebo-controlled, double-blind randomized trial conducted at the University of Alabama at Birmingham. 3. A total of 34 patients undergoing PCNL were randomly assigned to receive either a single 10 mg oral dose of baclofen or a placebo prior to surgery. 4. The results showed no significant difference in opioid use or pain scores between the baclofen and placebo groups. However, there was a significant positive correlation between preoperative opioid use and postoperative opioid consumption. 5. There were no significant differences in vital signs, side effects, or other medication use between the two groups. 6. The authors concluded that the analgesic benefits of preoperative baclofen were not observed at the 10 mg dose used in this study, and they suggest that higher doses or repeated dosing of baclofen may be needed to observe potential analgesic effects.

Reference –

Mandabach M, Deichmann P, Massoll A, et al. (July 10, 2024) Use of Baclofen Premedication as an Analgesic Adjuvant in Patients Undergoing Percutaneous Nephrolithotripsy: A Placebo-Controlled, Double-Blind Randomized Trial. Cureus 16(7): e64235. DOI 10.7759/cureus.64235