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Tristan Manalac, 16 May 2018
Although the conversion rate of ocular (OMG) to generalized (GMG) myasthenia gravis in Asian patients is low, thymoma and acetylcholine receptor (AchR) antibodies as well as positivity in repetitive nerve stimulation (RNS) studies all predict such generalization, a recent Singapore study has shown.

Preoperative gabapentinoids reduce postoperative pain in spine surgery

30 Sep 2017

Gabapentinoids, when delivered before spine surgery, seem to reduce postoperative pain, morphine-related complications and total morphine consumption, according to a new meta-analysis.

Pooled data from 16 studies showed that preoperative administration of gabapentinoids significantly reduced pain, as measured by the visual analogue scale (VAS), at 6 hours (weighted mean difference [WMD], -10.57; 95 percent CI, -14.52 to -6.63; p=0.02) after surgery.

VAS was also significantly reduced at 12 (WMD, -9.29; -11.74 to -6.85; p=0.000) and 24 (WMD, -7.19; -10.45 to -3.93; p=0.000) hours after surgery following preoperative gabapentinoid administration.

Morphine consumption at 24 hours postoperation was also significantly decreased after gabapentinioid administration (WMD, -18.55; -23.52 to -13.57; p=0.000). Moreover, pregabalin, a type of gabapentinoid, also significantly reduced cumulative consumption of morphine at 48 hours after surgery (WMD, -6.52; -7.78 to -5.25; p=0.000).

In terms of complication, preoperative gabapentinoids had no significant effect on the occurrence of sedation (risk ratio [RR], 1.29; 0.73 to 2.28; p=0.541), dizziness (RR, 1.44; 1.05 to 1.99; p=0.086) and headache (RR, 1.10; 0.70 to 1.73; p=0.431).

There were also no significant changes in the occurrence of somnolence (RR, 1.45; 0.90 to 2.34; p=0.142), visual disturbances (RR, 1.76; 0.90 to 2.34; p=0.142) and urine retention (RR, 0.61; 0.38 to 0.97; p=0.142).

In contrast, gabapentinoids significantly reduced the occurrence of nausea (RR, 0.69; 0.54 to 0.88; p=0.004), vomiting (RR, 0.51; 0.34 to 0.76; p=0.004) and pruritus (RR, 0.34; 0.22 to 0.55; p=0.001).

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Most Read Articles
Tristan Manalac, 16 May 2018
Although the conversion rate of ocular (OMG) to generalized (GMG) myasthenia gravis in Asian patients is low, thymoma and acetylcholine receptor (AchR) antibodies as well as positivity in repetitive nerve stimulation (RNS) studies all predict such generalization, a recent Singapore study has shown.