Arthroscopic bankart surgery: Does gabapentin reduce postoperative pain and opioid consumption? A triple-blinded randomized clinical trial

Mardani-Kivi, Mohsen; Mobarakeh, Mahmoud Karimi; Keyhani, Sohrab; Haghighi, Mohammad; Hashemi-Motlagh, Keyvan; Saheb-Ekhtiari, Khashayar

doi:10.1016/j.otsr.2016.01.028

Cited by 21 publications

(27 citation statements)

References 25 publications

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“…Gabapentin 2 hours preoperatively is recommended to administer because it can achieve the maximum plasma concentration 2-3 h after the injection. Since gabapentin has no hepatic metabolism and is excreted without change through the kidneys, gabapentin is well tolerant [18,41]. In this meta-analysis, gabapentin shows no increase in dizziness, but is associated with the decrease in nausea and vomiting, which may be derived from the reduction of analgesic consumption after the surgery.…”

Section: Discussionmentioning

confidence: 90%

“…Among the ve studies included here, two studies report pain scores at 6 h [18,19], three studies report pain scores at 24 h [18][19][20], two studies report analgesic consumption [18,19], four studies report dizziness [18][19][20]26], as well as four studies report nausea and vomiting [18,19,26,27]. Jadad scores of the ve included studies vary from 3 to 5, and all ve studies are considered to be high-quality ones according to quality assessment.…”

Section: Resultsmentioning

confidence: 99%

“…The application of gabapentin for the pain management of arthroscopy is not fully explored, and several studies reported the con icting results [18][19][20]. With accumulating evidence, we therefore perform a systematic review and meta-analysis of RCTs to explore the e cacy and safety of gabapentin in patients with arthroscopy.…”

Section: Introductionmentioning

confidence: 99%

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The analgesic evaluation of gabapentin for arthroscopy: a meta-analysis of randomized controlled trials

Huang

Yang

et al. 2020

Preprint

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Introduction: The efficacy of gabapentin for pain management of arthroscopy remains controversial. We conduct a systematic review and meta-analysis to explore the influence of gabapentin versus placebo on the postoperative pain intensity of arthroscopy. Methods We search PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through April 2020 for randomized controlled trials (RCTs) assessing the effect of gabapentin versus placebo on pain control of arthroscopy. This meta-analysis is performed using the random-effect model. Results Five RCTs are included in the meta-analysis. Overall, compared with control group for arthroscopy, gabapentin remarkably decreases pain scores at 24 h (Std. MD=-0.68; 95% CI=-1.15 to -0.02; P = 0.21), analgesic consumption (Std. MD=-18.24; 95% CI=-24.61 to -11.88; P < 0.00001), nausea and vomiting (OR = 0.42; 95% CI = 0.21 to 0.84; P = 0.01), but has no obvious influence on pain scores at 6 h (Std. MD=-1.30; 95% CI=-2.92 to 0.31; P = 0.11) or dizziness (OR = 1.12; 95% CI = 0.56 to 2.24; P = 0.75). Conclusions Gabapentin is effective for pain control after arthroscopy.

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Section: Discussionmentioning

confidence: 90%

Section: Resultsmentioning

confidence: 99%

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The analgesic evaluation of gabapentin for arthroscopy: a meta-analysis of randomized controlled trials

Huang

Yang

et al. 2020

Preprint

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“…Several other studies have also documented the efficacy of nonopioid oral medications after arthroscopy and other orthopaedic procedures. [12][13][14][15][16][17][18][19] Gimbel et al 14 studied a variety of orthopaedic procedures and concluded that celecoxib may serve as a better option for postoperative pain control compared with hydrocodone/acetaminophen. A recent study by Pham et al 19 showed that use of oral NSAIDs (ibuprofen) and limited narcotics resulted in excellent pain relief and patient satisfaction after arthroscopic meniscectomy, which supports our current findings for limited narcotics after an arthroscopic procedure.…”

Section: Discussionmentioning

confidence: 99%

Opioid Use Is Reduced in Patients Treated with NSAIDs After Arthroscopic Bankart Repair: A Randomized Controlled Study

Thompson

Klein

Alaia

et al. 2021

Arthroscopy, Sports Medicine, and Rehabilitation

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Purpose To evaluate the efficacy of oral nonsteroidal anti-inflammatory drugs (NSAIDs) as the primary postoperative pain medication compared with standard oral opioids after arthroscopic shoulder capsulolabral (Bankart) repair for recurrent anterior shoulder instability. Methods This was a single-center, prospective, randomized controlled study. Patients aged 18 to 65 years indicated for arthroscopic shoulder capsulolabral repair for recurrent anterior shoulder instability were included. Postoperatively, patients were prescribed 1 of 2 analgesic regimens: (1) 30 ibuprofen (600 mg every 6 to 8 hours as needed) and 10 tablets of oxycodone/acetaminophen (5/325 mg every 6 hours as needed for breakthrough pain) or (2) 30 tablets oxycodone/acetaminophen (5/325 mg every 6 hours as needed). Subjects completed questionnaires at 24, 48, and 96 hours and 1 week after surgery, which included questions about analgesic medication usage, visual analog scale (VAS) pain score, incidence of adverse events, and patient satisfaction. Results Between December 2017 and May 2019, 80 patients (mean age 31.3 ± 10.4 years) were enrolled. Overall there were no significant differences in VAS pain score or patient satisfaction between the 2 groups. Patients in the opioid-only group had a significantly higher mean opioid consumption on postoperative days (PODs) 2 to 4 (5.5 versus 2.9, P = .05) and after 1 week (11.7 versus 7.9 tablets, P = .05) compared with patients in the NSAID group. Of patients in the NSAID group, 17.5% experienced adverse effects, compared with 35% in the opioid-only group. Conclusions Use of oral NSAIDs with limited breakthrough opioids results in significantly less opioid use after arthroscopic Bankart repair in the first postoperative week compared with opioids only. Both groups used limited amounts of opioids to control postoperative pain. There were no differences in pain levels at any time point postoperatively or satisfaction between patient groups. Level of Evidence II, nonblinded randomized control trial.

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“…The risk of bias summary and risk of bias graph are provided in Figures 2 and 3, respectively. The risk of bias for selective reporting was unclear in 1 study 29 and low in 4 studies. 17,30,31,32 The rest all had low risk of bias.…”

Section: Study Characteristics and Bias Assessmentmentioning

confidence: 99%

Eficacia y seguridad de la analgesia preventiva con gabapentinoides para pacientes sometidos a cirugía artroscópica de hombro: una revisión sistemática y metanálisis

Galindo-Avalos

Colin-Vázquez²,

López-Valencia³

et al. 2019

Acta Ortopédica Mexicana

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Arthroscopic bankart surgery: Does gabapentin reduce postoperative pain and opioid consumption? A triple-blinded randomized clinical trial

Abstract: Level I, treatment study.

Cited by 21 publications

References 25 publications

The analgesic evaluation of gabapentin for arthroscopy: a meta-analysis of randomized controlled trials

The analgesic evaluation of gabapentin for arthroscopy: a meta-analysis of randomized controlled trials

Opioid Use Is Reduced in Patients Treated with NSAIDs After Arthroscopic Bankart Repair: A Randomized Controlled Study

Eficacia y seguridad de la analgesia preventiva con gabapentinoides para pacientes sometidos a cirugía artroscópica de hombro: una revisión sistemática y metanálisis

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