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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).

Editor's Recommendations
Most Read Articles
26 Aug 2017
Elderly individuals with high levels of serum uric acid may be at an increased risk of dementia, particularly vascular or mixed dementia, a study suggests.
14 Jan 2016
Tocotrienols are one of the two classes of compounds generally known as vitamin E. Prominent researcher in pharmaceutical technology, Professor Yuen Kah Hay, recently spoke to MIMS Doctor about the neuroprotective benefits conferred by palm tocotrienols. He shared key insights from a clinical trial performed by his team and about the compound’s potential for clinical use.
Elvira Manzano, 01 Feb 2014

There is no benefit to using ibuprofen over paracetamol in most patients with upper respiratory tract infections (URTIs). Steam inhalation therapy also does not offer any advantage, research has shown.

Dr. Joseph Delano Fule Robles, 01 Mar 2017

The tau and Aβ amyloid pathways have emerged as possible novel targets in treating Alzheimer’s disease (AD), according to studies discussed at the recently concluded Hong Kong Pharmacy Conference.