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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 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. Would you want to take Lyrica (pregabalin) or Neurontin (gabapentin) for pain relief after a major surgery? Both drugs belong to a class of nerve medication called gabapentinoids that are increasingly being prescribed to patients perioperatively (after surgery) as an alternative to opioid medication. Perioperative gabapentin upped the risk of delirium, new antipsychotic use, and pneumonia in older adults after major surgery, a retrospective study showed. Four unpublished studies met inclusion criteria; in three, participants had pain following dental surgery, and one followed major orthopaedic surgery; 177 participants were treated with a single dose of gabapentin 250 mg, 21 with gabapentin 500 mg, and 172 with placebo. 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. 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. One of the biggest issues we see after surgery is scarring around the nerves (1). The most common symptoms of nerve damage after surgery are usually numbness, tingling, burning, muscle weakness or atrophy. 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. Gabapentin, an anticonvulsant, has recently been suggested as an effective postoperative ‘analgesic’ agent. The objective of the present study was to examine the analgesic effectiveness, opioid-sparing effects and side effects associated with the use of gabapentin in a perioperative setting. 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. More than one-fifth of older adults prescribed gabapentin postoperatively filled a prescription >90 days after discharge, especially among patients with more comorbidities and concurrent prolonged opioid use, increasing the risk of adverse drug events and polypharmacy. 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 First, we repeated the analysis by defining gabapentin exposure on the day of surgery without requiring a 2-day minimum length of stay after surgery. Then, we explored a dose-response relationship using a 4-dose category of gabapentin (no use, 1 mg to <600 mg, 600 mg to <1200 mg, or ≥1200 mg). The Cleveland Clinic study had patients take a preemptive dose of three drugs: acetaminophen, the nerve pain medication gabapentin and the NSAID celecoxib (Celebrex). “Giving non-opioid pain medications before may help prevent the cascade of pain-causing chemicals that comes from your central nervous system after surgery,” explains Memtsoudis. undergoing elective or emergent surgery under any type of anesthesia were considered. Included trials had to evaluate gabapentinoids (pregabalin or gabapentin) initiated between 1 week before and 12h after surgery. At least one outcome measure had to be assessed to be considered for inclusion. Gabapentin is commonly indicated in the treatment of seizures. 27 Gabapentin, which acts on the nociceptive processes involved in central sensitization, has been shown to reduce hypersensitivity associated with nerve injury (hyperalgesia) and postoperative pain and inflammation in animal models. 28 Interestingly, gabapentin’s antiemetic 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. the effect of gabapentin on other endpoints: post- operative sleep, requirements for additional adjunctive pain medication and patient-perceived quality of recovery after surgery. MATERIALS AND METHODS After institutional approval and written informed consent were obtained from all subjects, 60 patients
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