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The findings obtained are therefore only due to the various doses of gabapentin. We found that a 600 mg dose of gabapentin given 1 hour before surgery is as effective as a 900 mg dose in PONV control and postoperative pain with lower side effects, but we suggest a multicenter study to validate and address the dilemma of different doses. from perioperative use of gabapentinoids is uncertain. The aim of this system-atic review was to assess the analgesic effect and adverse events with the perioperative use of gabapentinoids in adult patients. Methods: Randomized controlled trials studying the use of gabapentinoids in adult patients undergoing surgery were included. In all the trials, gabapentin was administered preoperatively as a single oral dose or two divided doses 2–24 hours before surgery at a dose ranging from 300 mg to 1,200 mg. This study also identified an association between cumulative gabapentin dose and reduction in morphine consumption. According to the head-to-head comparisons (eFigure 3A in Supplement 1), all different dosages of gabapentin and pregabalin have lower VAS scores than placebo except for gabapentin 400 mg, 800 mg, and pregabalin 75 mg. Also, there was no significant difference between all different dosages of gabapentin and pregabalin. A single preoperative dose of gabapentin was administered in 11 studies [9–19], and 10 studies described gabapentin administration given preoperatively and as continued therapy postoperatively [20–29]. The gabapentin dosing regimen was not described in one of the included publications . The most common preoperative dose of gabapentin was 10 RESULTS: Pain relief was better in the gabapentin groups compared with the control groups. The opioid-sparing effect during the first 24 h after a single dose of gabapentin 300-1200 mg, administered 1-2 h preoperatively, ranged from 20% to 62%. Pregabalin Dosing for preoperative orders for Ambulatory Orthopedic procedures 1) If patient is taking pregabalin already, just inform patient to take their regular dose on DOS and avoid ordering additional medication. Eleven studies (25,28–33,36,38–40) administered gabapentin as a single dose within 1 h to 2 h before surgery; the remainder involved initiating therapy on the day before surgery or continuing it for up to 10 days after surgery . Pre-operative gabapentin (600-1200 mg) reduces the amount of narcotics required in the post-anesthetic care unit (PACU). Pre-operative gabapentin does not decrease long-term narcotic use and is associated with increased side effects of respiratory depression, sedation, and falls. A single low dose of 600 mg gabapentin administered 1 h prior to surgery produced effective and significant postoperative analgesia after total mastectomy and axillary dissection without significant side effects. Appropriate perioperative medication management is essential to ensure positive surgical outcomes and prevent medication misadventures.1 Results from a prospective analysis of 1,025 patients admitted to a general surgical unit concluded that patients on at least one medication for a chronic disease are 2.7 times more likely to experience surgica Dosage: A typical dose range for perioperative gabapentin is 200-300 mg. Timing : It is usually administered the night before surgery to help manage preoperative anxiety and pain. Benefits : Gabapentin can reduce the need for opioids postoperatively, which helps in minimizing opioid-related side effects. We defined perioperative gabapentin use based on charge codes, which identify each service item (eg, medications and procedures) for billing and reimbursement purposes, on the day of surgery or postoperative day 1 or 2. We calculated total daily gabapentin dose (in milligrams) given during the exposure-defining period. Preoperative gabapentin is associated with significantly decreased levels of consciousness in a dose-dependent manner and longer postanesthesia care unit stays. 36,37 Similarly, respiratory depression has been reported in patients receiving preoperative gabapentin, with greater risk noted in older patients and those receiving multimodal An early study used a single preoperative dose, evaluated patients for only 4 hr postoperatively, and reported substantially (50%) less pain during movement and morphine consumption. An accompanying editorial heralded gabapentin as “a welcome addition to the anesthesiologist’s pharmacopoeia of ‘coanalgesics’”, and interest mushroomed. In the study of Pandey et al., increasing dosage of gabapentin from 600 mg to 1200 mg, did not show a reduction in pain scores after discectomy, then 600 mg gabapentin was determined as favorite dose for post discectomy pain reduction. In our study, regarding to type of surgery, which was a lower abdominal surgery, 400 mg of gabapentin Most have relied on pre-operative dosing and have utilized a single dose of 300 to 1200 mg. Higher doses seem to show a decrease in postoperative pain, a reduction in opioid requirement, and reduction in opioid related adverse effects such as nausea, vomiting, and ileus, with a propensity for causing sedation and dizziness. 1.1 A single 1000 mg dose of acetaminophen is recommended to be given preoperatively in open and laparoscopic colorectal surgical procedures (Level of evidence: Low) 1.2 A single 300 mg dose of gabapentin should be given be should be given preoperatively The effects of a preoperative dose of gabapentin on postoperative pain control was evaluated in previous recent studies as well: two performed in breast surgery patients (8,9), two in abdominal hysterectomy patients (10,12), one in patients having spinal surgery , and one in ear-nose-throat surgery .
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