Preoperative gabapentin for postoperative analgesia: a meta-analysis

Abstract

Purpose: Gabapentin's role in the treatment of chronic neuropathic pain is well known. What is less well established is its role for managing postoperative pain. In order to clarify whether gabapentin's utility in acute pain control is more than just theoretical, we conducted a meta-analysis of all randomized trials that addressed gabapentin's role in acute postoperative pain control. We specifically addressed whether gabapentin reduces pain scores, analgesia consumption, and/or analgesia-related side effects in the first 24 hr following surgery. Source:We identified eight placebo-controlled, randomized controlled trials and conducted a meta-analysis using the primary outcomes of pain scores, total analgesia consumption, and side effects over a 24-hr period. Principle findings:Patients who received gabapentin preoperatively reported significantly lower pain scores (-11.9 at rest and -11.0 with movement on a 100-point visual analogue scale) and opioid consumption (-14.7 mg of morphine in 24 hr) with no difference in the incidence of side effects. Conclusion:Although gabapentin given preoperatively decreases pain scores and analgesic consumption in the first 24 hr after surgery, the clinical significance of this finding has yet to be determined. This meta-analysis could not demonstrate a significant reduction in the incidence of side effects. Due to the small numbers enrolled in the studies, larger randomized control trials are warranted. Objectif : Le rôle de la gabapentine dans le traitement de la douleur neuropathique chronique est bien connu. Ce qui l'est moins, c'est son rôle dans le traitement de la douleur postopératoire. Pour le vérifier, nous avons fait une méta-analyse de toutes les études randomisées qui ont abordé le rôle de la gabapentine dans le contrôle de la douleur postopératoire aiguë. Nous avons surtout cherché si la gabapentine réduit les scores de douleur, la consommation d'analgésique et/ou les effets secondaires reliés à l'analgésie des 24 premières heures postopératoires. Source : Nous avons repéré huit études randomisées, contrôlées contre placebo et mené une méta-analyse en utilisant les principaux paramètres des scores de douleur, consommation totale d'analgésique et effets secondaires pendant 24 h.Constatations principales : Les patients qui ont reçu de la gabapentine préopératoire ont présenté des scores de douleur (-11,9 au repos et -11,0

A systematic review of intravenous ketamine for postoperative analgesia

“…When only median and interquartile range (IQR) were available, normal distribution was assumed, and SD was calculated using SD = IQR/1.349 as done in previous meta-analyses. 14 Standard difference in means was used as the effect size (ES) measurement to allow combining different opioids that have very different appropriate doses. There is reasonably good agreement among statisticians about ES interpretation for SDM.…”

Eficacia analgésica de una dosis única de dexametasona perineural en el bloqueo ecoguiado del nervio femoral en cirugía de prótesis total de rodilla

“…A pesar de los resultados esperanzadores obtenidos con la gabapentina y la pregabalina, no podemos recomendarlas para el postoperatorio de la PTR por la escasa evidencia que hay en este tipo de cirugía (Recomendación D, Evidencia 4) 81,82 .…”

The Effects of Pregabaline on Postoperative Pain and Opioid Consumption Used Perioperatively in Patients Undergoing Modified Radical Mastectomy

“…[21] Gabapentinin analjezik etkinliği farklı cerrahi gruplarında gösterilerek sonuçları birçok sistematik derlemede yayınlanmıştır. [17,18] Yeni bir gabapentin türevi olan pregabalin ise daha iyi bir farmakokinetik profil ve potense sahip olup multimodal ameliyat sonrası ağrı tedavisindeki etkinliğini araştıran yayınlar bildirilmektedir. [30] Pregabalinin, gabapentin ile benzer anti-hiperaljezik, antikonvülsan ve anksiyolitik özellikleri olmakla beraber, daha az olumsuz yan etkileri ve doz bağımsız absorbsiyonu vardır.…”

“…[11][12][13][14][15][16] Gabapentinin farklı cerrahi gruplarındaki analjezik etkinliği çok sayıda sistematik derlemede gösteril-miştir. [3,[17][18][19] Gabapentinden türetilen ve yeni bir gama-aminobütirik asit (GABA) analoğu olan pregabalin, daha iyi bir farmakokinetik profile, hızlı etki başlangıcına ve potense sahiptir. [10,20] Çalışmalar pregabalinin santral sinir sistemindeki voltaja duyarlı kalsiyum kanallarında bulunan a2-δ proteinine yüksek potensle bağlanan bir bileşik olduğunu göstermiştir.…”