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The development of chronic post surgical pain has attracted increased attention [53] and with central sensitization as a prerequisite, gabapentin with its ability to attenuate secondary hyperalgesia in pain models [54, 55], is an interesting "anti-hyperalgesic". Gabapentin may be prescribed either before or after surgery to help with postsurgical pain. However, it should be used with caution due to the high risk of abuse. Conclusion Gabapentin, pregabalin, and duloxetine have potential to further decrease post-operative pain and lower opioid dependency. This review creates an opening for further research in hand surgery to assess an updated protocol for pain management to reduce opioid dependency. The most common dose of gabapentin assessed was 1200 mg daily (12 studies), with some studies using doses as low as 300 mg daily (Table 1). Eleven studies (25, 28 – 33, 36, 38 – 40) administered gabapentin as a single dose within 1 h to 2 h before surgery; the remainder involved initiating therapy on the day before surgery or continuing it for up to 10 days after surgery (Table 1). With Gabapentin (1-aminomethyl-cyclohexaneacetic acid) is an amino acid that has the structure of the neurotransmitter γ-aminobutyric acid (GABA). It is a novel drug used for the treatment of postoperative pain with antihyperalgesic properties and a Would you want to take Lyrica (pregabalin) or Neurontin (gabapentin) for pain relief after a major surgery? Both drugs belong to a class of nerve medication called gabapentinoids that are increasingly being prescribed to patients perioperatively (after surgery) as an alternative to opioid medication. Post-operative gabapentin (600 mg) may be equally effective as a preoperative dose in decreasing PACU narcotic use. Level 3 Concomitant administration of gabapentin as part of a multi-modal pain management strategy including narcotics, non-steroidal anti-inflammatory drugs (NSAIDS), and muscle relaxants does not improve pain scores. Prescription of gabapentin and pregabalin in the perioperative period has become increasingly common, if not de rigueur. These gabapentinoids have become ubiquitous components of protocols for early recovery after surgery and multi-modal analgesia. High dose gabapentin taper may be considered for patients with concomitant post-operative pain and alcohol withdrawal to decrease benzodiazepine use (see Alcohol Withdrawal Guideline) Patients on gabapentin prior to admission should be resumed on gabapentin, if clinically appropriate Abstract Background: Perioperative pain treatment often consist of combinations of non-opioid and opioid analgesics, 'multimodal analgesia', in which gabapentin is currently used. The aim was to document beneficial and harmful effects of perioperative gabapentin treatment. Effective postoperative pain management is crucial in the care of surgical patients. Opioids, which are commonly used in managing postoperative pain, have a potential for tolerance and addiction, along with sedating side effects. Gabapentin’s use as Abstract Purpose of review: Gabapentinoid use has increased substantially in the past several years after initial promising data with regard to acute perioperative pain control. The purpose of this review is to critically appraise the evidence for the use of gabapentinoids for acute pain management and its impact on the development of chronic pain after surgery. Gabapentin is typically prescribed for pain management after surgery, but the duration of its use varies based on individual needs. The Role of Gabapentin in Post-Surgical Care Gabapentin has become a go-to medication for managing postoperative pain. Conclusion Gabapentin, pregabalin, and duloxetine have potential to further decrease post-operative pain and lower opioid dependency. This review creates an opening for further research in hand surgery to assess an updated protocol for pain management to reduce opioid dependency. This cohort study examines whether perioperative gabapentin use among older adults after major surgery is associated with in-hospital adverse clinical events. Outcomes and Data Analyses The primary outcome is prolonged use of gabapentin in the postoperative period, defined as a prescription refilled at 90-180 days after discharge from surgery, a time period based on definitions of prolonged use of opioids after surgical procedures. 20, 25, 26 We calculated the days’ supply and average daily dose. This review evaluated the efficacy and tolerability of peri-operative gabapentin administration to control acute post-operative pain. Peri-operative gabapentin administration was found to be effective in reducing pain scores, opioid requirements and opioid-related adverse effects in the first 24 hours after surgery. Given the significant differences between the studies and the possibility of Firm evidence for use of gabapentin is lacking as clinically relevant beneficial effect of gabapentin may be absent and harm is imminent, especially when added to multi-modal analgesia. Editorial Comment In this trustworthy systematic review, use of gabapentin for post-operative pain management was scrutinized. This randomized clinical trial evaluates the effects of perioperative administration of gabapentin on postoperative pain resolution and time to cessation of opioid use. Gabapentin, an anticonvulsant, has been proposed as an effective analgesic within enhanced recovery after surgery (ERAS) protocols to minimize opioid consumption and reduce postoperative nausea and vomiting (PONV). However, its role in perioperative pain management lacks consensus, necessitating a systematic review and meta-analysis. Methods
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