Sirinkarn Sookdee, MD¹ , Penmas Teeravanittrakul, MD¹

Background: Tonsillectomy is a common surgical procedure in otolaryngology, which causes severe postoperative pain that leads to difficulty eating, and the patient may require additional analgesics. However, surgeons can reduce postoperative pain by administering various analgesics. Opioid and nonopioid analgesics are generally used to relieve postoperative pain, but they have meaningful adverse effects. Gabapentin has recently been a potential medication to relieve postoperative pain in many surgical procedures.

Objective: To compare the effects of gabapentin administration before or after tonsillectomy in reducing postoperative pain.

Materials and Methods: A total of 120 patients who underwent tonsillectomy were enrolled. All participants were randomly assigned to three groups: preoperative, postoperative gabapentin administration, and placebo groups. Visual analogue scale (VAS) was recorded. The presence of adverse effects was assessed. All participants received follow-up in the first week.

Results: The mean daily VAS at rest decreased significantly in postoperative gabapentin administration groups on the first day, compared with placebo (p=0.003), as well as during swallowing (p=0.044). Both groups significantly reduced opioid use compared with placebo (p<0.001) without serious side effects.

Conclusion: Postoperative gabapentin administration could reduce postoperative pain on the first day without significant side effects in patients undergoing tonsillectomy.

Received 24 October 2025 | Revised 26 February 2026 | Accepted 27 February 2026

J Med Assoc Thai 2026;109(6):520-4

DOI: 10.35755/jmedassocthai.2026.6.03757