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. 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%. This cohort study examines whether perioperative gabapentin use among older adults after major surgery is associated with in-hospital adverse clinical 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 But gabapentinoids also have risks and there is little evidence to support their use for postoperative pain relief, according to a large new study by a team of Canadian researchers. “No clinically significant analgesic effect for the perioperative use of gabapentinoids was observed. 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. 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. 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. 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 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 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 Results: 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%. 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. Gabapentin enacarbil is a prodrug with an extended-release formulation that has been proposed for multimodal postoperative analgesia, but the drug's efficacy for major arthroplasties remains unclear. Materials and methods: We enrolled 60 adult patients scheduled for primary knee or hip arthroplasty expected to remain hospitalized for at least 3 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. 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 Peri-operative gabapentin administration is effective in reducing pain scores, opioid requirements and opioid-related adverse effects in the first 24 hours after surgery. No serious side-effects were observed, though sedation was associated with gabapentin use. 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. Less commonly used pain medications such as gabapentinoids have been shown to provide small reductions in postoperative pain and opioid use after surgery (including orthopaedic surgery) (Verret et al. 2020); however, perioperative use of gabapentin has been associated with increased harms such as delirium and pulmonary complications (Park et al
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