Gabapentin (Neurontin) or pregabalin (Lyrica): These are medications that specifically treat certain seizures and nerve pain. However, doctors may prescribe them before your surgery to reduce Based on the current meta-analysis, gabapentin exerts an analgesic and opioid-sparing effect in acute postoperative pain management without increasing the rate of dizziness and pruritus. Total knee arthroplasty (TKA) is one of the most common surgeries performed on patients with osteoarthritis or rheumatic arthritis of the knee. The literature search was conducted by following databases: Medline, Cochrane database, ClinicalTrials.gov, PubMed, and Embase. The following keywords including pain management, postoperative pain, total knee arthroplasties, total knee replacement, and gabapentin were used for searching. 1. Inclusion criteria. Studies were considered eligible 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 A state-of-the-art pain protocol for total knee replacement David F. Dalury, MD University of Maryland St Joseph Orthopedics, Towson Orthopaedic Associates, Towson, MD, USA article info Article history: Received 21 December 2015 Received in revised form 15 January 2016 Accepted 16 January 2016 Available online xxx Keywords: Total knee Gabapentin (NeurontinTM) has gained significant interest as part of a multi-modal pain management strategy for the control of acute pain. There has been considerable variation in both the dose and the regimen used in recent clinical trials. Another type of medicine used as part of a multimodal pain regimen after joint replacement are medicines that target nerve pain – namely gabapentin (Neurontin) or pregabalin (Lyrica). Using these medications decreases the amount of opioids required after joint replacement. Some patients report that these medicines cause drowsiness, but they In this randomized, double-blind, placebo-controlled dose-finding study, 300 opioid-naive patients scheduled for total knee arthroplasty were randomized (1:1:1) to either gabapentin 1300 mg/d (group A), gabapentin 900 mg/d (group B), or placebo (group C) daily from 2 hours preoperatively to postoperative day 6 in addition to a standardized multi Pain management after total knee arthroplasty (TKA) varies and has been widely studied in recent years. Some randomized controlled studies have carried out to evaluate the effects of gabapentin on pain relief after TKA. The following medical subject heading terms, keywords, and their combinations were used: “postoperative pain, total hip arthroplasty, total knee arthroplasty, total hip replacement, total knee replacement and gabapentin”. No restrictions were imposed on language or geographic location. Inclusion and exclusion criteria The key words and medical subject heading terms included the following: gabapentin, pain control, total knee arthroplasty, total knee replacement, TKA, and TKR. These key words and the corresponding medical subject heading terms were combined with the Boolean operators AND and OR. 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. 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 review explores the evidence supporting the use of gabapentoids (eg. Lyrica®) in surgical fields, then in orthopaedics more specifically, and finally in the targeted domain of total knee replacement (TKR) surgery. The concept of 'pre-emptive' analgesia is also explored. Abstract. Gabapentin is routinely used in preoperative multimodal anesthesia to reduce pain following total joint arthroplasty (TJA) surgery. Evolving evidence has shown it is ineffective in reducing postoperative pain and should be used cautiously in this patient population due to its adverse effects. Gabapentinoid (GABA) prescribing has substantially increased as a nonopioid analgesics for surgical conditions. We examined the effectiveness of GABA use for postoperative pain control among patients receiving total knee arthroplasty (TKA). The American Association of Hip and Knee Surgeons (AAHKS), The American Academy of Orthopaedic Surgeons (AAOS), The Hip Society, The Knee Society and The American Society of Regional Anesthesia and Pain Medicine (ASRA) have worked together to develop evidence-based guidelines on the use of gabapentinoids in primary total joint arthroplasty (TJA). A total of 1805 patients aged 18 to 75 years scheduled for surgery (thoracotomy, video-assisted thoracoscopic surgery, total hip replacement, total knee replacement, mastectomy, breast lumpectomy, hand surgery, carpal tunnel surgery, knee arthroscopy, shoulder arthroplasty, and shoulder arthroscopy) were screened. 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 this recovery, most of which has focused on improvements in perioperative pain control. Various protocols have been suggested. 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