Study results do not support Gabapentinoids use for postoperative pain management
Canada: Routine use of pregabalin or gabapentin is not effective for the management of postoperative pain in adults, a recent study in the journal Anesthesiology has found. This is because the perioperative use of gabapentinoids did not result in clinically significant analgesic effects. Also, there was no effect on the prevention of postoperative chronic pain.
Gabapentinoids are widely used for acute pain management yet the clinical benefit from its perioperative use is uncertain. Michael Verret, Université Laval Research Center, Québec City, Québec, Canada, and colleagues conducted this systematic review to assess the analgesic effect and adverse events with the perioperative use of gabapentinoids in adult patients.
This meta-analysis included randomized controlled trials that studied the use of gabapentinoids in adult patients undergoing surgery. In total 281 trials consisting of 24,682 participants were included.
The primary outcome was the intensity of postoperative acute pain. Secondary outcomes included the intensity of postoperative subacute pain, incidence of postoperative chronic pain, cumulative opioid use, persistent opioid use, lengths of stay, and adverse events.
Key findings of the study include:
- Compared with controls, gabapentinoids were associated with a lower postoperative pain intensity (100-point scale) at 6 h, 12 h, 24 h, and 48 h.
- This effect was not clinically significant ranging below the minimally important difference (10 points out of 100) for each time point.
- These results were consistent regardless of the type of drug (gabapentin or pregabalin).
- No effect was observed on pain intensity at 72 h, subacute and chronic pain.
- The use of gabapentinoids was associated with a lower risk of postoperative nausea and vomiting but with more dizziness and visual disturbance.
"No clinically significant analgesic effect for the perioperative use of gabapentinoids was observed. There was also no effect on the prevention of postoperative chronic pain and a greater risk of adverse events. These results do not support the routine use of pregabalin or gabapentin for the management of postoperative pain in adult patients," concluded the authors.
The study, "Perioperative Use of Gabapentinoids for the Management of Postoperative Acute Pain: A Systematic Review and Meta-analysis," is published in the journal Anesthesiology.