The efficacy of gabapentin in reducing pain intensity and postoperative nausea and vomiting following laparoscopic cholecystectomy

Abstract

Background:It is unknown whether gabapentin is effective in reducing acute pain following laparoscopic cholecystectomy. The purpose of the current meta-analysis was to evaluate the efficacy of gabapentin in reducing pain intensity and postoperative nausea and vomiting (PONV) after laparoscopic cholecystectomy.Methods:All randomized controlled trials (RCTs) evaluating the efficacy of gabapentin in reducing pain intensity and PONV after laparoscopic cholecystectomy were searched on the following databases: PubMed, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), the Google database, the Chinese Wanfang database, and the China National Knowledge Infrastructure (CNKI). The most recent literature search was conducted on March 21, 2017. Outcomes including visual analog scale (VAS) at 12 and 24 hours, total morphine consumption, and the occurrence of PONV. Continuous outcomes were expressed as the weighted mean difference (WMD) and 95% confidence interval (CI), and the one discontinuous outcome was expressed as risk ratio (RR) and 95% CI. Stata 12.0 software was used for meta-analysis.Results:A total of 9 studies involving 966 patients were identified. In total, there were 484 gabapentin subjects and 482 controls. Compared with the control group, gabapentin was associated with lower VAS at 12 hours (WMD = −10.18, 95% CI: −17.36 to −2.80, P = .007) and 24 hours (WMD = −6.33, 95% CI: −8.41 to −4.25, P = .000), which was equivalent on a 110-point VAS scale to 10.18 points at 12 hours and 6.33 points at 24 hours. Compared with the control group, gabapentin was associated with less total morphine consumption by approximately 110.83 mg (WMD = −110.83, 95% CI: −183.25 to −38.42, P = .003). In addition, the occurrence of nausea and vomiting in gabapentin was decreased (25.2% vs 47.6, RR = 0.53, 95% CI: 0.44–0.63, P = .000).Conclusion:Gabapentin was efficacious in reducing postoperative pain, total morphine consumption, and morphine-related complications following laparoscopic cholecystectomy. In addition, there was a negative correlation between the gabapentin dosage and the occurrence of nausea and vomiting. The number of included studies is limited, and more studies are needed to verify the effects of gabapentin in laparoscopic cholecystectomy patients.

Dual‐trajectories of opioid and gabapentinoid use and risk of subsequent drug overdose among Medicare beneficiaries in the United States: a retrospective cohort study

“…Recently, several clinical trials have suggested the efficacy of GABA use for off-label pain conditions (e.g. chronic sciatica; irritable bowel syndrome) and for reducing acute and chronic postoperative pain and OPI use [50][51][52][53][54][55]. However, given the safety concerns about GABAs, there have been calls for placing more stringent regulations on gabapentin at the federal level and to include gabapentin monitoring in state prescription drug monitoring programs (PDMPs) to promote safety.…”

The efficacy of gabapentin in reducing pain intensity and morphine consumption after breast cancer surgery

“…[ 29 , 30 ] And preoperative use of gabapentin was associated with a pain relieving in total knee and hip arthroplasty, spinal surgery and laparoscopic cholecystectomy. [ 31 – 35 ] Results from current meta-analysis indicated that gabapentin can decrease acute and chronic pain after breast cancer surgery. Results showed that gabapentin can decrease the pain scores by 16.14 and 27.33 points on 110-points after surgery and 24 hours, respectively.…”

Comparison of efficacy of gabapentin and memantine premedication in laparoscopic cholecystectomies for postoperative pain relief – A randomised placebo controlled trial

“…had concluded that gabapentin reduced pain scores at 12 and 24 h post-operatively in laparoscopic cholecystectomies. [ 1 ] In the studies included, the dosage varied from 300 to 1200 mg of gabapentin predominantly given as a single pre-medication dose only. The adverse events of gabapentin are dose-dependent as per the metaanalysis, and hence we used 600 mg of gabapentin.…”

“…A combination of opioid and non-opioid analgesic drugs improves analgesic efficacy and reduces the side effects of individual drugs. [ 1 ]…”

“…Gabapentin is used in laparoscopic cholecystectomy due to opioid-saving effect and less incidence of nausea and vomiting. [ 1 2 ] N--methyl-D-aspartate (NMDA) receptor antagonists such as memantine have emerged in the treatment of acute post-operative pain as they have analgesic properties and excellent safety records as quoted in few studies. [ 3 4 5 6 7 ]…”