(1) Objectives: evaluate the effect of three pre- drug combinations of gabapentin , celecoxib , and acetaminophen in reducing anxiety, pain , need for postoperative morphine consumption and side effects in adult patients were Distal femoral fracture surgery plating. (2) Design: Randomized controlled trial. (3) Setting and conduct: Sample size of 100 patients will randomly assign into intervention (preemptive analgesia) or control (placebo) group and will be treated in academic orthopedic hospital. (4) Inclusion criteria: age between 25 to 45 years, ASA versus I and II. Exclusion criteria: failure of spinal anesthesia or if take more than 90 minutes. (5) Interventions: one hour before surgery, under the direct supervision of a nurse who was unaware of the status of drug or placebo to patients three oral gabapentin (600 mg dose), celecoxib (200 mg dose) and acetaminophen (500 mg dose) plus 50cc water is fed to the case group and control group given a placebo. (6) Main outcome measures: Primary outcome is VAS score of pain which will be assessed at 1, 2, 3, 4, 8 and 12 hour after surgery, the first analgesic request after resolution of spinal anesthesia, opioid consumption and respiratory rate, pulse oximetry, heart rate, blood pressure and other side effects mentioned temporal resolution within 24 hours checked, STAI anxiety criteria.