Successful implementation of an Enhanced Recovery After Surgery program shortens length of stay and improves postoperative pain, and bowel and bladder function after colorectal surgery. BMC Anesthesiol. 2016;16 (1):55. doi: 10.1186/s12871-016-0223-0 PubMed Google Scholar. A multimodal regimen for THA was described in a recent study evaluating the use of gabapentin 600 mg before or after surgery. 28 One to 2 hours preoperatively, patients received acetaminophen 1 g orally, celecoxib 400 mg orally, dexamethasone 8 mg intravenously, and spinal anesthesia (0.5% hypobaric bupivacaine [15 mg/3 mL] with fentanyl 10 mcg studies investigated gabapentin compared to placebo and six studies investigated pregabalin compared to placebo.[2–14] Despite these high quality studies, only a limited amount of meta- analyses were performed due to inconsistency in outcomes reported and the timepoints at which In the absence of either criteria, discontinue prior to surgery. Irreversible MAO antagonists may require 2 weeks after discontinuation of drug for normal MAO function to return. Therefore these medications should be tapered and discontinued two weeks before elective surgery. This review evaluated the efficacy and tolerability of peri-operative gabapentin administration to control acute post-operative pain. Peri-operative gabapentin administration was found to be effective in reducing pain scores, opioid requirements and opioid-related adverse effects in the first 24 hours after surgery. Given the significant differences between the studies and the possibility of Optimization of perioperative analgesia has important implications for patient satisfaction and short-term outcomes. This study’s purpose is to assess if preoperative gabapentin or intraoperative ketorolac influences postoperative pain or time to discharge following hip arthroscopy. Yu L, Ran B, Li M, et al. Gabapentin and pregabalin in the management of postoperative pain after lumbar spinal surgery: a systematic review and meta-analysis. Spine 2013; 38:1947–1952. [Google Scholar] 10. Hwang SH, Park IJ, Cho YJ, et al. The efficacy of gabapentin/pregabalin in improving pain after tonsillectomy: a meta-analysis. Another type of medicine used as part of a multimodal pain regimen after hip replacement are medicines that target nerve pain – namely gabapentin (Neurontin) or pregabalin (Lyrica). Using these medications decreases the amount of opioids required after hip replacement. Some patients report that these medicines cause drowsiness, but they are Their findings, recently published in the journal Anesthesiology, indicate that the analgesic benefits of pregabalin and gabapentin after surgery are negligible, regardless of the dose or type of operation. Gabapentinoids were also ineffective in preventing chronic pain from developing after surgery, one of the primary justifications for using The administration of gabapentin is effective in decreasing postoperative narcotic consumption and the VAS score. Keywords: Gabapentin, Total hip arthroplasty, Meta-analysis. Background. Total hip arthroplasty (THA) is a common and successful surgery in modern medicine, but it is often associated with intense postoperative pain . Pre-emptive Background Pain management after total hip arthroplasty (THA) varies and has been widely studied in recent years. Gabapentin as a third-generation antiepileptic drug that selectively affects the nociceptive process has been used for pain relief after THA. This meta-analysis was conducted to examine the efficacy of gabapentin in THA. Methods An electronic-based search was conducted using the Background: Pain management after total hip arthroplasty (THA) varies and has been widely studied in recent years. Gabapentin as a third-generation antiepileptic drug that selectively affects the nociceptive process has been used for pain relief after THA. 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. A subgroup analysis showed that gabapentinoids reduced pain on movement on postoperative day two after total knee arthroplasty but not hip arthroplasty. There was insufficient data to examine the efficacy of gabapentinoids in the reduction of chronic postoperative pain in knee/hip surgery. Perioperative gabapentin, 1200 mg, administered preoperatively plus 600 mg every 8 hours continued for 72 hours after surgery did not affect time to pain cessation, the rate of pain resolution, or the proportion of patients with chronic pain at 6 months or 1 year following surgery. 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 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. This meta-analysis was performed to assess the efficacy and safety of gabapentin following TKA and THA. Method Electronic databases 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%. Sometimes drugs that target nerves like gabapentin are given out too; these can help when regular pills aren’t enough by themselves. They’re part of a bigger plan for handling pain after hip replacement surgery without relying just on strong opioids which keeps recovery safe and sound for everyone involved. 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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