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Preoperative gabapentin for postoperative analgesia: a meta-analysis

[L’administration préopératoire de gabapentine pour l’analgésie postopératoire: une méta-analyse]

Rachael K. Seib, MA^* and James E. Paul, MD MSc FRCPC

^* From the School of Undergraduate Medicine,; and the
Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada.

Address correspondence to: Ms. Rachael Seib, 20 Hatt Street, Dundas, Ontario L9H 2E8, Canada. Phone: 905-628-5430; E-mail: rachaelseib{at}sympatico.ca

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.

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