Seib Rachael K, Paul James E
School of Undergraduate Medicine, McMaster University, Hamilton, Ontario L9H 2E8, Canada.
Can J Anaesth. 2006 May;53(5):461-9. doi: 10.1007/BF03022618.
Gabapentin's role in the treatment of chronic neuropathic pain is well known. What is less well established is its role for managing postoperative pain. In order to clarify whether gabapentin's utility in acute pain control is more than just theoretical, we conducted a meta-analysis of all randomized trials that addressed gabapentin's role in acute postoperative pain control. We specifically addressed whether gabapentin reduces pain scores, analgesia consumption, and/or analgesia-related side effects in the first 24 hr following surgery.
We identified eight placebo-controlled, randomized controlled trials and conducted a meta-analysis using the primary outcomes of pain scores, total analgesia consumption, and side effects over a 24-hr period.
Patients who received gabapentin preoperatively reported significantly lower pain scores (-11.9 at rest and -11.0 with movement on a 100-point visual analogue scale) and opioid consumption (-14.7 mg of morphine in 24 hr) with no difference in the incidence of side effects.
Although gabapentin given preoperatively decreases pain scores and analgesic consumption in the first 24 hr after surgery, the clinical significance of this finding has yet to be determined. This meta-analysis could not demonstrate a significant reduction in the incidence of side effects. Due to the small numbers enrolled in the studies, larger randomized control trials are warranted.
加巴喷丁在治疗慢性神经性疼痛中的作用已广为人知。但其在术后疼痛管理中的作用尚不太明确。为了阐明加巴喷丁在急性疼痛控制中的效用是否不仅仅是理论上的，我们对所有探讨加巴喷丁在急性术后疼痛控制中作用的随机试验进行了荟萃分析。我们特别关注加巴喷丁是否能降低术后头24小时内的疼痛评分、镇痛药消耗量和/或与镇痛相关的副作用。
我们确定了八项安慰剂对照的随机对照试验，并使用疼痛评分、24小时内总镇痛药消耗量和副作用等主要结果进行了荟萃分析。
术前接受加巴喷丁治疗的患者报告疼痛评分显著更低（在100分视觉模拟量表上，静息时为-11.9，活动时为-11.0），阿片类药物消耗量更低（24小时内为-14.7毫克吗啡），且副作用发生率无差异。
尽管术前给予加巴喷丁可降低术后头24小时内的疼痛评分和镇痛药消耗量，但这一发现的临床意义尚待确定。该荟萃分析未能证明副作用发生率有显著降低。由于纳入研究的人数较少，有必要进行更大规模的随机对照试验。
