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Similarly, aside from 24 h after surgery, gabapentin significantly reduced pain with movement (25–27,31,34,35,37,38) by 18% to 28% (VAS 8.2 mm to 10.2 mm) after surgery . The pooled effects on VAS pain scores displayed significant heterogeneity, which was not explained by subgroup analyses based on surgical procedure, gabapentin dose or study 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). 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. degenerative spine diseases. We performed a search in PubMed, Embase, and The Cochrane Library for randomized controlled trials. The primary outcome was opioid consumption after 24 hours postoperatively. We performed meta-analyses, trial sequential analyses, and Grading of Recommendations assessment to accommodate systematic errors. Forty-four randomized controlled trials were included with 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. Following spine surgery, the majority of patients report moderate to severe pain that lasts at least 3–4 days. This pain can be severe and debilitating affecting recovery and discharge from the hospital. This can prolong hospital stays and increase the 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 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 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. 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 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 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. Much of the literature regarding gabapentin’s benefits in treating postoperative pain have focused on patients undergoing general surgery. Few studies have focused on the spine surgery population, and of those that have been performed, evidence suggests that gabapentin is beneficial. 27-29 However, given this 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 Oral gabapentin was efficacious in the management of postoperative pain at all time points during the first day after surgery (SMD, -1.91 at 0-6 hr, -1.30 at 6-12 hr, -1.05 at 12-24 hr, respectively). 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 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 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. Objective: To evaluate and compare the analgesic efficacy, adverse effects, and clinical utility of gabapentin and pregabalin in postoperative pain management, long-term functional outcome, and quality of life in patients undergoing spinal surgery.
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