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In this cohort study, perioperative gabapentin use was associated with increased risk of delirium, new antipsychotic use, and pneumonia among older patients after major surgery. These results suggest careful risk-benefit assessment before prescribing gabapentin for perioperative pain management. 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. 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. To our knowledge, this is the first prospective study assessing the use of gabapentin in cardiothoracic surgery patients. Methods: Gabapentin was prescribed to 60 consecutive out-patients with refractory pain persisting at four weeks or more after thoracic surgery or trauma. Follow-up of 45 patients (75%) was performed for a median of 21 months 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 The primary outcome was prolonged use of gabapentin, defined as a fill>90 days after discharge. To identify risk factors for prolonged use, we constructed logistic regression models, adjusted for procedure and patient characteristics, length of stay, disposition location, and care complexity. 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 Purpose of review: This review summarizes the risks and benefits of gabapentinoids (gabapentin and pregabalin) for perioperative pain control and the controversies surrounding their use in a variety of settings. We review current literature with the goal of providing patient-centric and procedure-specific recommendations for the use of these 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. We recommend being selective with regard to using gabapentinoids for acute postoperative pain management after careful consideration of the potential side effect profile based on patient comorbidities as well as the expected severity of postoperative pain. 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 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. Perioperative gabapentin upped the risk of delirium, new antipsychotic use, and pneumonia in older adults after major surgery, a retrospective study showed. Multimodal analgesia has been an increasingly adopted strategy in the Enhanced Recovery After Surgery pathway, 1 which aims to reduce opioid use by using nonopioid analgesia, such as regional or epidural analgesia, nonsteroidal anti-inflammatory drugs, acetaminophen, and gabapentinoids. 2 Randomized clinical trials (RCTs) have demonstrated that There was a reduction in required opioid requirement in the 72 hours after surgery. There was a moderate increased risk of ataxia, falls, and visual disturbance in the gabapentinoid group as well as a low increased risk of delirium, respiratory depression, and dizziness. To our knowledge, we report the results of the first randomized trial of perioperative use of gabapentin with extensive postoperative longitudinal follow-up and patient contact totaling 19 511 telephone calls up to 2 years after surgery. Perioperative gabapentin, 1200 mg, administered preoperatively plus 600 mg every 8 hours continued for 72 In response to the opioid crisis, surgeons nationwide have sought to decrease opioid use by adopting opioid-sparing multimodal medication regimens to treat perioperative pain. 1 For example, gabapentinoids (gabapentin and pregabalin) are now commonly administered during the perioperative period as part of “enhanced recovery after surgery Exposures Gabapentin use within 2 days after surgery. Main Outcomes and Measures The primary outcome was delirium, identified using diagnosis codes, and secondary outcomes were new antipsychotic use, pneumonia, and in-hospital death between postoperative day 3 and hospital discharge. To reduce confounding, 1:1 propensity score matching was The findings contradict guidelines published by the American Pain Society (APS) in 2016, which advocate “around the clock” use of gabapentin, pregabalin and other nonopioid drugs both before and after surgery.
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