Analgesic Effects of Gabapentin after Spinal Surgery

Abstract

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.

Preoperative gabapentin for postoperative analgesia: a meta-analysis

“…The surgeries included abdominal hysterectomy, 21,22 radical mastectomy or lumpectomy, 19,23 vaginal hysterectomy, 17 laparoscopic cholecystectomy 18 and lumbar discectomy or spinal fusion. 24,25 Due to the nature of the surgeries, four of the trials evaluated female patients only. One study did not evaluate side effects.…”

“…17,18,22,24,25 This difference was most pronounced at 12-18 hr postoperatively. While the study by Fassoulaki et al, 19 which measured pain at rest as well as pain on mobilization, found no significant difference in visual analogue scale scores at rest during the first 24 hr postoperatively, it did find significantly lower resting pain scores in the gabapentin group by the third postoperative day.…”

Perioperative gabapentin as a component of multimodal analgesia for postoperative pain after total knee arthroplasty

“…Pre-procedural gabapentin treatment is also effective in treating pain during spinal, otolaryngological, gynecological, and endoscopic procedures, and burn wound debridement [9,15,16,[22][23][24][25]. Some studies suggest that it reduces the stress response that may occur during laryngoscopy and tracheal intubation [26].…”

Gabapentin provides effective postoperative analgesia whether administered pre-emptively or post-incision

“…7 As gabapentin enhances the analgesic effects of morphine in healthy volunteers and the combination produces better analgesia in comparison with morphine alone, 8 the drug may exert a selective effect on the nociceptive process involved in central neuronal sensitization, and is the rationale for its use in the treatment of acute postoperative pain. 9 The antihyperalgesic effects of gabapentin result from an action at the α 2 -Δ subunits of voltage dependent Ca ++ channels which are up-regulated in the dorsal root ganglia and spinal cord after peripheral injury. 9,10 Gabapentin may also produce antihyperalgesia by decreasing glutaminergic transmission in the spinal cord.…”

“…9 The antihyperalgesic effects of gabapentin result from an action at the α 2 -Δ subunits of voltage dependent Ca ++ channels which are up-regulated in the dorsal root ganglia and spinal cord after peripheral injury. 9,10 Gabapentin may also produce antihyperalgesia by decreasing glutaminergic transmission in the spinal cord. 11 In addition, it may inhibit central neuronal sensitization and hyperalgesia through an action at voltage dependent Ca ++ channels resulting in a direct postsynaptic or pre-synaptic inhibition of Ca ++ influx that decreases excitatory amino acid neurotransmission.…”