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In addition, a high dose (≥900 mg/d) of gabapentin is more effective than a low dose (<900 mg/d). The number of included studies is limited, and more studies are needed to verify the effects of gabapentin in spinal surgery patients. Keywords: gabapentin, meta-analysis, spine surgery. 1. Introduction Gabapentin was efficacious in the reduction of postoperative pain, total morphine consumption, and morphine-related complications following spine surgery. In addition, a high dose (≥900 mg/d) of gabapentin is more effective than a low dose (<900 mg/d). Methods: This study was conducted in 90 patients belonging to the 18 to 75 age group of either sex undergoing spinal surgery under general anesthesia. Group A received 300 mg of gabapentin, group B received 75 mg of pregabalin, whereas group C received placebo 1 dose 1 hour before surgery and 8 hourly for 7 days, thereafter. Our study focused on patients undergoing spine surgery and found that gabapentin 900 mg per day before spine surgery was associated with the lowest VAS pain score among all dosages, and no differences in adverse events were noted among all treatments. Background: Pain management after spinal surgery has been studied for years. Gabapentin is a third-generation antiepileptic drug that selectively affects the nociceptive process and has been used for pain relief after surgery. However, the relationship between gabapentin and postoperative pain in spinal surgery is still controversial. This study evaluates the effect of perioperative gabapentin on pain and opioid use in elderly patients after elective posterior lumbar fusion. It does not find any benefit of gabapentin in reducing postoperative pain or opioid consumption in the acute period. Opioid Management. Opioids remain a mainstay therapy for patients undergoing spine surgery. However, opioid therapy can also result in a number of adverse effects including nausea, vomiting, constipation, ileus, urinary retention, sedation, and respiratory depression. 5 Given increased attention to opioid-related adverse effects including persistent postoperative opioid use, opioid misuse, and The total fentanyl consumed after surgery in the first 24 h in the gabapentin group (233.5±141.9) was significantly less than in the placebo group (359.6±104.1; p<0.05). Turan et al., 2006 22 Turkey: Prospective: 40 patients Lower extremity surgery: Gabapentin (n= 20) 1.2 g 1 day before and for 2 days after surgery We defined new postoperative gabapentin as fills for 7 days before surgery until 7 days after discharge. We excluded patients whose discharge disposition was hospice or death. The primary outcome was prolonged use of gabapentin, defined as a fill>90 days after discharge. Gabapentin and the related, more potent compound pregabalin have been shown to be beneficial in the treatment of neuropathic pain as well as postoperative pain following spinal surgery and hysterectomy. Conclusion: This work suggested that both gabapentin and pregabalin were efficacious in reduction of postoperative pain and narcotic requirements after lumbar spinal surgery, whereas more trials were needed to further assess the efficacy of pregabalin in the management of postoperative pain after lumbar spinal surgery. A retrospective review of gabapentin use in five pain protocols for posterior spinal fusion in AIS patients across a multi-hospital system. Gabapentin reduced opioid use but had no effect on length of stay or pain scores. A significant number of RCTs have demonstrated conflicting results in the use of preoperative gabapentin. 19 Bharti et al 20 studied gabapentin administration among patients (n=40) undergoing mastectomy (20 received gabapentin and 20 received placebo) and demonstrated a reduction in the amount of morphine required during the initial 24 hours Postoperative pain and long-term functional outcome after administration of gabapentin and pregabalin in patients undergoing spinal surgery. Spine (Phila Pa 1976). 2014;39:E363–8. Article Google Scholar Kim SI, Park DY, Ok SY, Kim SC. Effect of pre-emptive Gabapentin on Postoerative pain after mastectomy. Our study focused on patients undergoing spine surgery and found that gabapentin 900 mg per day before spine surgery was associated with the lowest VAS pain score among all dosages, and no differences in adverse events were noted among all treatments. Preoperative oral gabapentin decreased pain scores in the early postoperative period and postoperative morphine consumption in spinal surgery patients while decreasing some morphine-associated side effects. A meta-analysis of 281 trials found no analgesic effect of gabapentin or pregabalin for postoperative pain, and higher risk of adverse events. The study contradicts guidelines that recommend gabapentinoids as opioid alternatives after surgery. Neuropathic pain after spinal surgery, the so-called failed back surgery syndrome (FBSS), is a frequently observed troublesome disease entity. Although medications may be effective to some degree, many patients continue experiencing intolerable pain They found that gabapentin resulted in a 35% reduction in total analgesic consumption in the first 24 hours following surgery. Gabapentin also resulted in 27% to 39% reduction in visual analog scale (VAS) pain scores in the first 24 hours postoperatively.
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