Background: Postoperative pain after total knee arthroplasty (TKA) and total hip arthroplasty (THA) influence patients' rehabilitation and life quality. Although gabapentin has been widely used for analgesia, its efficacy is still controversial in TKA and THA. Total knee replacement Pain control Early rehabilitation Local infiltration analgesia abstract Total knee replacement is acknowledged as a successful and durable operation, but recovery from this surgery is often lengthy and painful. A great deal of attention has recently been directed at enhancing Postoperative pain after total knee arthroplasty (TKA) and total hip arthroplasty (THA) influence patients’ rehabilitation and life quality. Although gabapentin has been widely used for analgesia, its efficacy is still controversial in TKA and THA. For example, a gabapentin dose of 1.2 grams per day 1 hour before surgery and for 2 days after CABG surgery showed that postoperative pain scores at 1, 2, and 3 days as well as the consumption of tramadol given as a rescue analgesic were significantly lower in the gabapentin group when compared to the placebo group . Additionally, preemptive In summary, the administration of gabapentin was effective in decreasing postoperative narcotic consumption and the incidence of pruritus. There was a high risk of selection bias and a higher heterogeneity of knee flexion range in this analysis. Gabapentin (Neurontin) or pregabalin (Lyrica): These are medications that specifically treat certain seizures and nerve pain. However, doctors may prescribe Trusted Source. pain after the We would like to show you a description here but the site won’t allow us. Overall, 17,970 patients (3% of all eligible patients) had a new prescription for gabapentin after surgery. Of these, the mean age was 73 years-old and 62% were female. The most common procedures were total knee (45%) and total hip (21%) replacements. Prolonged use occurred in 22%. To our knowledge, we report the results of the first randomized trial of perioperative use of gabapentin with extensive postoperative longitudinal follow-up and patient contact totaling 19 511 telephone calls up to 2 years after surgery. Perioperative gabapentin, 1200 mg, administered preoperatively plus 600 mg every 8 hours continued for 72 Gabapentin resulted in less total patient-controlled analgesia (PCA) morphine use over 48 hours postoperatively (P <0.05), better active knee flexion on postoperative days (PODs) 2 and 3 (P <0.05 for both), and less pruritus (P <0.05) than placebo.¹⁰. The Cleveland Clinic study had patients take a preemptive dose of three drugs: acetaminophen, the nerve pain medication gabapentin and the NSAID celecoxib (Celebrex). “Giving non-opioid pain medications before may help prevent the cascade of pain-causing chemicals that comes from your central nervous system after surgery,” explains Memtsoudis. ed in the Medline, Embase, PubMed, Cochrane Controlled Trials Register (CENTRAL), Web of Science, Google, and Chinese Wanfang databases. This systematic review and meta-analysis were performed according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement criteria. The primary endpoint was the visual analogue scale (VAS) score after TKA with rest or Pregabalin is accepted to be more potent, and with fewer adverse effects, than its class counterpart gabapentin. It has fast gastrointestinal absorption, a high bioavailability, and its serum representation is dose-proportional leading to a predictable and near-linear pharmacokinetic profile. 6 The maximum plasma concentration is reached at 1 h after oral administration, and its elimination Gabapentinoids, gabapentin, and pregabalin, have been gaining attention in postoperative pain management. Methods: We conducted a meta-analysis to evaluate the efficacy of gabapentinoids in pain management after knee and hip surgery. Clarke H, Katz J, McCartney C, et al. Perioperative gabapentin reduces 24 h opioid consumption and improves in-hospital rehabilitation but not post-discharge outcomes after total knee arthroplasty with peripheral nerve block. Clarke HA, Katz J, McCartney CJ, et al. Perioperative gabapentin reduces 24 h opioid consumption and improves in-hospital rehabilitation but not post-discharge outcomes after total knee arthroplasty with peripheral nerve block. Postoperative pain after total knee arthroplasty (TKA) and total hip arthroplasty (THA) influence patients’ rehabilitation and life quality. Although gabapentin has been widely used for analgesia, its efficacy is still controversial in TKA and THA. Would you want to take Lyrica (pregabalin) or Neurontin (gabapentin) for pain relief after a major surgery? Both drugs belong to a class of nerve medication called gabapentinoids that are increasingly being prescribed to patients perioperatively (after surgery) as an alternative to opioid medication. However, FNB induces quadriceps weakness, which, combined with the muscle loss after knee surgery, may impair postoperative mobilisation. 115 Also, continuous blocks have been incriminated in the risk of falls. 213 Therefore, it has been replaced with ACB, which demonstrates similar analgesic efficacy to FNB but seems to better preserve Pregabalin after discharge reduces postoperative pain, neuropathic pain, and opioid consumption after primary TJA, but gabapentin does not reduce pain or opioid consumption. Strength of Recommendation: Strong. Rationale: Six high quality studies evaluated the efficacy of post-discharge gabapentinoids on pain
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