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One article described the effects of gabapentin on traumatic nerve injury or post-surgery nerve pain and found that gabapentin provided significantly better pain relief when compared to placebo, with more patients having at least a 30% pain reduction and less sleep interference due to pain. 28 Dolgun et. al. assessed the acute neuropathic pain Evidence suggests that the pain after laparoscopic cholecystectomy stems from somatic due to incisional pain and surgical trauma to the abdominal walls at the trocar port insertion sites. 3, 4 Another component of postoperative pain after laparoscopic cholecystectomy is visceral pain which is classified as intra-abdominal pain caused by the manipulation and distention of the intra-abdominal Gabapentin, an anticonvulsant, has recently been suggested as an effective postoperative ‘analgesic’ agent. The objective of the present study was to examine the analgesic effectiveness, opioid-sparing effects and side effects associated with the use of gabapentin in a perioperative setting. In a recent nationwide shift, surgeons have sought to decrease postoperative opioid prescribing by adopting the use of non-opioid ‘multimodal’ pain regimens. 1–4 Gabapentinoids (gabapentin and pregabalin) are now commonly administered during the postoperative period for many surgical patients, especially with the rise in adoption of We (1) systematically reviewed the published literature pertaining to the prevention of CPSP (≥ 2 months after surgery) after perioperative administration of gabapentin and pregabalin and (2) performed a meta-analysis using studies that report sufficient data. Nerve pain medications. Drugs such as gabapentin (Neurontin) or pregabalin (Lyrica) can help calm any neuropathic, or nerve-related, pain stemming from the surgery that can’t be controlled with these other drugs. Opioids. If the three options above aren’t enough to quell the pain, then opioids should be added. While the CDC’s controversial opioid guideline does not advocate using gabapentinoids for post-surgical pain, it does recommend their use in treating chronic pain -- with little to no mention of their side effects. Gabapentin is commonly indicated in the treatment of seizures. 27 Gabapentin, which acts on the nociceptive processes involved in central sensitization, has been shown to reduce hypersensitivity associated with nerve injury (hyperalgesia) and postoperative pain and inflammation in animal models. 28 Interestingly, gabapentin’s antiemetic Perioperative use of gabapentin has a significant 24-hour opioid sparing effect and improves pain score for both abdominal hysterectomy and spinal surgery. Nausea may be reduced in abdominal hysterectomy. 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. day trial, patients in the gabapentin group showed improved VAS pain scores and improved Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) scores compared to patients in the naproxen group. In 2006, Sihoe et al. evaluated gabapentin in the treatment of chronic pain after chest surgery (6). This was a heterogeneous group of patients. Gabapentin appears safe and well tolerated when used for persistent post-operative and post-traumatic pain in thoracic surgery patients, although minor side effects do occur. Gabapentin may relieve refractory chest wall pain in some of these patients, particularly those with more severe pain. Furthe 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 Background: Perioperative pain treatment often consist of combinations of non-opioid and opioid analgesics, 'multimodal analgesia', in which gabapentin is currently used. The aim was to document beneficial and harmful effects of perioperative gabapentin treatment. This steady decrease in the mean pain score difference between gabapentin and placebo may be attributed to the reported half-life of gabapentin, which is around 7 hours. 39 The overall reduction in pain score in the current review was comparable to an earlier review examining the efficacy of gabapentin in spinal surgery. 18 • Gabapentinoids such as gabapentin and pregabalin are often included in perioperative multimodal analgesia regimens in an attempt to reduce acute, subacute, and chronic pain after surgery • Current American Pain Society and European Society of Regional Anaesthesia and Pain Therapy guidelines offer conflicting recom- Gabapentin is a novel drug used for the treatment of postoperative pain with antihyperalgesic properties and a unique mechanism of action, which differentiates it from other commonly used drugs. Various studies have shown that perioperative use of gabapentin reduces postoperative pain. Of the 11 trials, 8 studied gabapentin, 4 of which (i.e., 50%) found that perioperative administration of gabapentin decreased the incidence of chronic pain more than 2 months after surgery. The purpose of this review is to critically appraise the evidence for the use of gabapentinoids for acute pain management and its impact on the development of chronic pain after surgery. Recent findings: Recent meta-analyses have revealed that prior data likely have overestimated the beneficial effects of gabapentinoids in acute perioperative To identify patients eligible to newly receive gabapentin for perioperative pain management, we excluded those who received gabapentin before surgery, had other indications or contraindications for gabapentin, or received critical care, mechanical ventilation, or a feeding tube in the immediate perioperative period.
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