Preoperative gabapentin augments intraoperative hypotension and reduces postoperative opioid requirements with functional endoscopic sinus surgery

Mohammed, Mahmoud Hassan; Fahmy, Adel Mikhail; Hakim, Karim Youssef Kamal

doi:10.1016/j.egja.2012.02.008

Cited by 23 publications

(39 citation statements)

References 16 publications

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“…A total of 135 studies were included . One hundred and thirty‐two trials with 9498 patients were included for the evaluation of benefit and furthermore, three non‐randomized studies were included for the evaluation of harm.…”

Section: Resultsmentioning

confidence: 99%

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Gabapentin for post‐operative pain management – a systematic review with meta‐analyses and trial sequential analyses

Fabritius

Geisler

Petersen

et al. 2016

Acta Anaesthesiol Scand

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O. (2016). Gabapentin for postoperative pain management-a systematic review with meta-analyses and trial sequential analyses. This article included Trial Sequential Analyses (TSA) of the random-effects models used to adjust the confidence intervals (CI) for possible sparse data and repetitive testing. Unfortunately, due to a bug in the TSA program, the required information size (RIS) for continuous outcomes were calculated twice the correct value. There was no error in the calculations of RIS for dichotomous outcomes. However, even with an upgrade of the GRADE evaluation of the effect on the co-primary outcome of 24 hrs morphine consumption from 'very low' to 'low' the conclusions still hold and should not be changed. Accordingly, the authors present corrections for the following passages in the article: In the Abstract, Results section:

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Section: Resultsmentioning

confidence: 99%

“…Sixteen trials had overall low risk of bias . Seventy‐seven trials had high and 39 trials unclear risk of bias . Reasons for unclear and high risk of bias were mainly ‘selective outcome reporting’ or ‘other bias’ (Fig.…”

Section: Resultsmentioning

confidence: 99%

Gabapentin for post‐operative pain management – a systematic review with meta‐analyses and trial sequential analyses

Fabritius

Geisler

Petersen

et al. 2016

Acta Anaesthesiol Scand

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show abstract

“…No other systematic review or meta‐analysis was found pertaining to perioperative and postoperative analgesic use for endoscopic sinus surgeries. Thirty‐two studies met the inclusion criteria for this project: all of the included studies were randomized, controlled trials (RCTs). Using the Cochrane Bias tool, we judged 4 studies to be at high risk, 21 to be at moderate risk, 6 to be at low risk, and 1 to be at unclear risk of bias.…”

Section: Resultsmentioning

confidence: 99%

Perioperative analgesia for patients undergoing endoscopic sinus surgery: an evidence‐based review

Svider

Nguyen

Yuhan

et al. 2018

Int Forum Allergy Rhinol

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There is evidence supporting the use of NSAIDs and gabapentin for the control of pain after endoscopic sinus surgery. Acetaminophen, α-agonists, and local anesthetics are also viable options for postoperative analgesia. Familiarity with these data is essential to facilitate the use of opioid alternatives. Further large-scale, multi-institutional, randomized trials are needed to provide conclusive recommendations for these perioperative analgesics.

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“…Other non‐narcotic analgesics can also be effective after FESS. Gabapentin has been demonstrated to be effective in multiple surgical procedures, including FESS, when given pre‐ and perioperatively . Sphenopalatine blockade with lidocaine or longer acting anesthetics have also been shown to be effective in perioperative pain control .…”

Section: Discussionmentioning

confidence: 99%

Multicenter study on the effect of nonsteroidal anti‐inflammatory drugs on postoperative pain after endoscopic sinus and nasal surgery

Walgama

Genç

et al. 2019

Int Forum Allergy Rhinol

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Background:The taboo of avoiding nonsteroidal antiinflammatory drugs (NSAIDs) a er functional endoscopic sinus surgery (FESS) has been waning. The impetus to reduce opioid prescriptions in view of the opioid epidemic led the authors to change their practices to include NSAIDs a er sinus surgery. This study's aim was to analyze the differences between patients before and a er we began recommending NSAIDs a er FESS. Methods:A prospective cohort study was performed on patients undergoing FESS or other endoscopic nasal surgeries at 3 institutions, by 5 rhinologists and 1 facial plastic surgeon. Before introducing NSAIDs, all patients were given a prescription for hydrocodone-acetaminophen 5/325 mg and also recommended preferentially to use acetaminophen 325 mg. A er the addition of NSAIDs, ibuprofen 200 mg and acetaminophen 325 mg were recommended preferentially, using the narcotic as a rescue medication. Patients kept a pain diary and medication log, and gave a visual analog scale (VAS) score for overall pain. Demographics, surgical variables, and comorbidities were also analyzed. Results:One hundred sixty-six total patients were recruited and had data that could be analyzed (65 without NSAIDs, 101 with NSAIDs). Overall, mean pain VAS score was 3.12 ± 1.95 for the non-NSAID group and 2.33 ± 2.30 for the NSAID group (p value = 0.006). The day with the highest mean pain was the first postoperative day. The mean number of total opioid pills taken was 6.94 ± 6.85 without NSAIDs vs 3.77 ± 4.56 with NSAIDs (p = 0.018). Age and gender were found to be the only consistently significant patient variables to affect pain. There were no bleeding complications.Conclusion: NSAID use was introduced into the practices of 5 practicing rhinologists and 1 facial plastic surgeon. No bleeding complications were seen. Both pain and overall opioid usage were reduced significantly. C 2019 ARS-AAOA, LLC.

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Preoperative gabapentin augments intraoperative hypotension and reduces postoperative opioid requirements with functional endoscopic sinus surgery

Cited by 23 publications

References 16 publications

Gabapentin for post‐operative pain management – a systematic review with meta‐analyses and trial sequential analyses

Gabapentin for post‐operative pain management – a systematic review with meta‐analyses and trial sequential analyses

Perioperative analgesia for patients undergoing endoscopic sinus surgery: an evidence‐based review

Multicenter study on the effect of nonsteroidal anti‐inflammatory drugs on postoperative pain after endoscopic sinus and nasal surgery

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