Background: Preemptive administration of analgesic medication is more effective than medication given after the onset of the painful stimulus. This study aimed to evaluate the effect of gabapentin plus celecoxib as pre-emptive multimodal analgesia on anxiety score, patient satisfaction score, visual analog scale (VAS), and analgesic requirement. Methods: This randomized double-blind controlled clinical trial was carried out at Minia University Hospital. Fifty adult patients ASA I and II undergoing elective complex spine surgery. Patients were divided into two groups, 25 patients in each group; group A received 300mg gabapentin + 200mg celecoxib 2 hours before surgery; group B (placebo) received two placebo capsules orally 2 hours before surgery. Anxiety score, patient satisfaction, VAS, and perioperative analgesic requirements were assessed. Results: anxiety score was significantly lower in the study group compared with a control group (1.2±0.5) versus (3.8±1.7), respectively. The time for the first request for postoperative analgesia showed statistically highly significant longer duration in the study group compared to the control group, and the total dose of fentanyl required during the first 24 h post-operatively showed highly statistically significantly lower values in the study group compared to control group (P < 0.0001). There was a significant difference between the study and control groups in patient satisfaction and VAS (p=<0.0001 and p=<0.001) respectively. Conclusion: Preemptive administration of multimodal analgesia as a combination of gabapentin 300mg plus celecoxib 200mg 2hr preoperative in the patients undergoing complex spine surgery provided lower anxiety, analgesic requirement, and led to a high patient satisfaction score.