Table 1 Included, randomized, double-blind, controlled studies of gabapentin in postoperative pain.
Reference | Quality Score | Surgical procedure | η gabapentin/placebo | Gabapentin dosing & administration | Analgesic and delivery | Effect on analgesic consumption (24 hours) | Effect on pain score at rest (6 h) | Effect on pain score at rest (24 h) | Side-effects |
|---|---|---|---|---|---|---|---|---|---|
Dierking 2004 [27] | 5 | Abdominal hysterectomy | 39/32 | 1200 mg 1 h pre-op. + 600 mg × 3 | PCA – morphine | Morphine reduced from 63 to 43 mg | NS | NS | NS |
Turan 2004a [28] | 5 | Abdominal hysterectomy | 25/25 | 1200 mg 1 h pre-op. | PCA – tramadol intravenously | Tramadol reduced from 420 to 270 mg | VAS lower with gabapentin (P = 0.000) | VAS lower with gabapentin (P = 0.000) | NS |
Gilron 2004 [30] | 5 | Abdominal hysterectomy | 23/24 | 600 mg 1 h pre-op. + 600 mg × 2 | PCA -morphine | Morphine reduced from 82 to 57 mg | VAS lower with gabapentin (P < 0.001) | VAS lower with gabapentin (P < 0.02) | Sedation increased with gabapentin |
Turan 2006a [29] | 5 | Abdominal hysterectomy | 25/25 | 1200 mg 1 h pre-op. | PCA -morphine | Morphine reduced from 53 to 41 mg | VAS lower with gabapentin (P < 0.01) | VAS lower with gabapentin (P < 0.05) | NS |
Fassoulaki 2006 [31] | 3 | Abdominal hysterectomy | 25/28 | 400 mg × 4 initiated day before surgery | PCA – morphine | Morphine reduced from 26 to 20 mg | NS | NS | |
Pandey 2004a [32] | 4 | Lumbar discoidectomy | 28/28 | 300 mg 2 h pre-op. | Fentanyl on demand | Fentanyl reduced from 360 to 234 ug | VAS lower with gabapentin (P < 0.05) | VAS lower with gabapentin (P < 0.05) | NS |
Pandey 2005a [24] | 5 | Lumbar discoidectomy | 4 × 20/20 | 300–600–900–1200 mg 2 h pre-op. (4 diff. groups) | PCA-fentanyl | Fentanyl reduced from 1218 to 627–988 ug | VAS lower with gabapentin (P < 0.05) | VAS lower with gabapentin (P < 0.05) | NS |
Turan 2004b [33] | 5 | Lumbar discoidectomy or spinal fusion | 25/25 | 1200 mg 1 h pre-op. | PCA-morphine | Morphine reduced from 43 to 16 mg | VAS lower with gabapentin. (P < 0.01) | NS | Vomiting reduced with gabapentin |
Radhakrishnan 2005 [34] | 4 | Lumbar discoidectomy/laminectomy | 30/30 | 400 mg night before surgery + 400 mg 2 h pre-op. | PCA-morphine (study lasted for 8 h) | NS (study lasted for 8 h) | NS | NS | |
Dirks 2002 [35] | 5 | Radical mastectomy | 31/34 | 1200 mg 1 h preop. | PCA-morphine (study lasted for 4 h) | Morphine reduced from 29 to 15 mg | VAS lower with gabapentin (P < 0.018) | NS | |
Fassoulaki 2002 [36] | 4 | Matectomy or lumpectomy with axillary dissection | 22/24 | 400 mg × 3 starting the evening before surgery | On demand. (Propoxyphene & paracetamol given i.m.) | NS | NS | NS | NS |
Pandey 2005b [26] | 5 | Nefrectomy | 2 × 20/20 | Pre-incision (2 h pre-op.)/post-incision groups. 600 mg in both. | PCA-fentanyl | Fentanyl reduced from 925 to 563 ug/624 ug | VAS lower with gabapentin in both groups (P < 0.05) | VAS lower with gabapentin in both groups (P < 0.05) | NS |
Bartholdy 2006 [38] | 5 | Laparascopic sterilization | 38/38 | 1200 mg 1/2 h pre-op. | PCA-morphine (Study lasted for 4 h) | NS | NS | NS | NS |
Pandey 2004b [37] | 3 | Laparascopic chole-cystectomy | 153/153 | 300 mg 2 h pre-op. | Fentanyl on demand. | Fentanyl reduced from 356 to 221 ug | VAS lower with gabapentin (P < 0.05) | VAS lower with gabapentin (P < 0.05) | Sedation + PONV increased with gabapentin |
Omran 2005 [39] | 5 | Pulmonal lobectomy | 25/25 | 1200 mg 1 h pre-op. and 600 mg × 2 | PCA-morphine | Morphine reduced from 32 to 24 mg | VAS lower with gabapentin (P < 0.05) | VAS lower with gabapentin (P < 0.05) | NS, vomiting reduced with gabapentin |
Tuncer 2005 [25] | 1 | Major orthopedic surgery | 2 × 15/15 | 1200 – 800 mg 1 h pre-op. | PCA-morphine (Study lasted only 4 hours) | Morphine reduced from 21 to 11 mg/15 mg | NS | NS | |
Menigaux 2005 [40] | 5 | Arthroscopic anterior cruciate ligament repair | 20/20 | 1200 mg 1–2 h preop. | PCA-morphine | Morphine reduced from 48 to 21 mg | NS | NS | NS |
Adam 2006 [41] | 5 | Arthropscopic shoulder surgery | 27/26 | 800 mg 2 h pre-op. | Nerveblock + on demand paracetamol + propoxyphene | NS | NS | NS | NS |
Turan 2007 [42] | 5 | Hand surgery | 20/20 | 1200 mg 1 h pre-op. | IVRA + diclofenac according to VAS score | Diclofenac reduced from 63 to 30 mg | NS | NS | NS |
Turan 2006b [43] | 5 | Lower extremity plastic surgery | 20/20 | 1200 mg 1 h pre-op. | PCEA bolus (bupivacaine and fentanyl) | PCEA bolus reduced with gabapentin | VAS lower with gabapentin (P < 0.001) | NS | NS, dizziness increased with gabapentin |
Al-Mujadi 2006 [45] | 5 | Thyroid surgery | 37/35 | 1200 mg 2 h pre-op. | Morphine according to VAS score | Morphine reduced from 30 to 15 mg | VAS lower with gabapentin (P < 0.01) | VAS lower with gabapentin (P < 0.01) | NS |
Mikkelsen 2006 [46] | 5 | Tonsillectomy | 22/27 | 1200 mg 1 h pre-op. + 600 mg × 2 | Morphine on demand + tbl. Ketobemidone by patient | Morphine NS. Ketobemidone reduced from 4.5 to 2.0 mg | NS | NS | Dizziness & vomiting increased with gabapentin |
Turan 2004c [44] | 5 | Ear-Nose-Throat surgery | 25/25 | 1200 mg 1 h pre-op. | Diclofenac according to VAS | Diclofenac reduced from 111 to 33 mg | VAS lower with gabapentin (P < = .001) | VAS lower with gabapentin (P < 0.001) | NS, dizziness increased with gabapentin |