Efficacy of perioperative gabapentin use in patients with idiopathic scoliosis undergoing fusion surgery: a systematic review and meta-analysis

Jose Luis Bas, Paloma Bas, Fernando Bonilla, Gonzalo Mariscal, Silvia Pérez, Miquel Bovea-Marco, Pedro Antonio Rubio-Belmar, Teresa Bas

May 2023, pp 1 - 12 Review Article Read Full Article

First Online: 20 May 2023

Purpose

This study aimed to assess whether the perioperative use of gabapentin was associated with decreased opioid use.

Methods

A meta-analysis was performed using PubMed, Embase, Scopus, and Cochrane Library. The randomized clinical trials included were focused on patients with adolescent idiopathic scoliosis who underwent posterior fusion surgery and were treated with gabapentin versus placebo medicine. The primary outcomes were opioid consumption at 24, 48, 72, and 96 h; time to introduction of oral medication, length of hospital stay, and period of urinary catheterization were also recorded. Data were combined using the Review Manager 5.4 software.

Results

Four randomized clinical trials with a pool of 196 adolescent patients (mean age: 14.8 ± 2.0 years) were included. At 24 and 48 h after surgery, opioid consumption was significantly lower in the gabapentin group: (standardized mean difference [SMD]: -0.50; 95% confidence interval [CI] − 0.79 to − 0.22) and (SMD: − 0.59; 95% CI − 0.88 to − 0.30), respectively. At 72 and 96 h, there were no significant differences between studies: (SMD: − 0.19; 95% CI − 0.52 to 0.13) and (SMD: 0.12; 95% CI − 0.25 to 0.50), respectively. Regarding the administration type, there were significant differences in favor of the 15 mg/kg subgroup with 600 mg at 48 h (SMD: − 0.69; 95% CI − 1.08 to − 0.30). There were no significant differences concerning the time to introduction of oral medication (MD: − 0.08; 95% CI − 0.39 to 0.23), hospitalization time (MD: − 0.12; 95% CI − 0.40 to 0.16), or period of urinary catheterization (SMD: − 0.27; 95% CI − 0.58 to 0.05).

Conclusions

Gabapentin decreased opioid consumption during the first 48 h. Doses of 15 mg/kg showed superiority in reducing opioid consumption in the first 48 h.

Level of evidence I

Diagnostic: individual cross-sectional studies with consistently applied reference standard and blinding.

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