NEW YORK (Reuters Health) – An analysis of trial data suggests that perioperative use of the antiepileptic agent gabapentin, now used for chronic pain conditions, can reduce pain and opioid use following abdominal hysterectomy and spinal surgery.
In recent years, more and more trials have surfaced supporting the use of gabapentin for postoperative analgesia, note Dr. Ole Mathiesen and colleagues in the July issue of BMC Anesthesiology. Prior meta-analyses looking at this topic have pooled data from studies of very different surgical procedures, so it was difficult to gauge the benefit in a particular surgical setting. By contrast, the primary focus of the present review was on two procedures: abdominal hysterectomy and spinal surgery.
For their investigation, Dr. Mathiesen and colleagues from Copenhagen University Hospital in Glostrup, Denmark, searched MEDLINE and other databases for trials comparing gabapentin with placebo for postoperative pain relief. A total of 23 studies, which included 1529 patients, were identified, the report indicates.
Sixteen of the studies included data on postoperative opioid requirements. In 12 of these studies, gabapentin use was associated with a significant reduction in opioid use.
Analysis of data from five trials on abdominal hysterectomy showed a reduction in morphine use and improvements in early pain scores at rest and during activity with gabapentin use. Similar findings were seen in four trials looking at the effects of the drug after spinal surgery.
There was also evidence that gabapentin reduced the nausea seen after abdominal hysterectomy, the authors state.
"Future trials in this area should include gabapentin as part of a multimodal postoperative treatment strategy, with focus on both acute and chronic pain states. Pain score during mobilization is mandatory, and the effect of gabapentin on postoperative delirium needs further exploration," the team concludes.
BMC Anesthesiology 2007;7.