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Background and Aims Post-operative pain management in patients undergoing total hip and total knee arthroplasties (THA, TKA) can be challenging. Gabapentinoids, drugs normally used for patients with chronic neuropathic pain, are often used in the perioperative setting as an adjunct therapy to ameliorate patient’s analgesia and decrease opioid consumption. Several metanalysis have been conducted to investigate the effect of gabapentinoids’ preoperative administration, showing negative results in most cases. Conversely, a meta-analysis from Han et al. showed a reduced post-operative opioid consumption in patients treated with pre-operative gabapentin.
Methods We conducted a case-control observational study on 135 patients undergoing a total hip or a total knee arthroplasty. Our primary outcome was to assess if there was any statistically significant difference in pain scores at several timepoints. In our center, the gabapentin was administered as a single, low dose preoperative oral dose.
Results 55 patients received a pre-operative dose of gabapentin. The numerical rating score (NRS) was 2.5 and 1 point lower in the gabapentin group, respectively at 6 hours and 18 hours after the surgery, when compared to the patients that did not receive gabapentin, with a meaningful difference. The other observed timepoints did not show a significant result. The post-operative length of stay (LOS) in the post-anaesthesia unit and the overall LOS were similar in the two groups.
Conclusions In out analysis, the use of a low dose of preoperative gabapentin was safe and effective in reducing the postoperative pain scores in the first day post-surgery. However, its effect run out 24 hours after the surgery.
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