Baos Sarah, Lui Mandy, Walker-Smith Terrie, Pufulete Maria, Messenger David, Abbadi Reyad, Batchelor Tim, Casali Gianluca, Edwards Mark, Goddard Nick, Abu Hilal Mohammed, Alzetani Aiman, Vaida Marius, Martinovsky Petr, Saravanan Palinikumar, Cook Tim, Malhotra Rajiv, Simpson Anna, Little Ross, Wordsworth Sarah, Stokes Elizabeth, Jiang Jingjing, Reeves Barnaby, Culliford Lucy, Collett Laura, Maishman Rachel, Chauhan Nilesh, McCullagh Liz, McKeon Holly, Abbs Samantha, Lamb Jenny, Gilbert Anna, Hughes Chloe, Wynick David, Angelini Gianni, Grocott Mike, Gibbison Ben, Rogers Chris A
Bristol Trials Centre, University of Bristol, Bristol, United Kingdom.
Bristol Medical School, University of Bristol, Bristol, United Kingdom.
Anesthesiology. 2025 Oct 1;143(4):851-861. doi: 10.1097/ALN.0000000000005655. Epub 2025 Jul 15.
Gabapentin is an anticonvulsant medication with approval for use in neuropathic pain and epileptic disorders. It is frequently added to multimodal analgesic regimens during and after surgery to reduce opioid use while controlling pain effectively. There is little evidence to show its effectiveness in major surgery.
In this multicenter, double-blinded randomized controlled trial, adults undergoing major cardiac, thoracic, or abdominal surgery were randomized to receive either gabapentin (600 mg before surgery, 300 mg twice daily for 2 days after surgery) or placebo. The primary outcome was length of hospital stay. Secondary outcomes included acute and chronic pain, total opioid use, adverse health events, and health-related quality of life. Patients were followed up daily in-hospital until discharge and then at 4 weeks and 4 months after surgery.
A total of 1,196 participants were randomized (500 underwent cardiac, 346 thoracic, and 350 abdominal surgery); 596 were allocated to placebo, and 600 were allocated to gabapentin. Median length of hospital stay was similar in the two groups (gabapentin, 5.94 [interquartile range (IQR), 4.08 to 8.04] days; placebo, 6.15 [IQR, 4.22 to 8.97] days; hazard ratio, 1.07; 95% CI, 0.95 to 1.20; P = 0.26). Overall, 384 participants experienced one or more serious adverse events (gabapentin, 189 of 596 [31.7%]; placebo, 195 of 599 [32.6%]), with some variation across surgical specialties.
Among patients undergoing major cardiac, thoracic, and abdominal surgery, adding gabapentin to multimodal analgesic regimes did not alter the length of hospital stay or the number of serious adverse events.
加巴喷丁是一种抗惊厥药物，已被批准用于治疗神经性疼痛和癫痫疾病。在手术期间及术后，它常被添加到多模式镇痛方案中，以减少阿片类药物的使用，同时有效控制疼痛。几乎没有证据表明其在大手术中有效果。
在这项多中心、双盲随机对照试验中，接受心脏、胸部或腹部大手术的成年人被随机分为两组，分别接受加巴喷丁（术前600毫克，术后2天每天两次，每次300毫克）或安慰剂。主要结局指标是住院时间。次要结局指标包括急性和慢性疼痛、阿片类药物总用量、不良健康事件以及与健康相关的生活质量。患者在住院期间每天接受随访直至出院，然后在术后4周和4个月进行随访。
共有1196名参与者被随机分组（500人接受心脏手术，346人接受胸部手术，350人接受腹部手术）；596人被分配到安慰剂组，600人被分配到加巴喷丁组。两组的中位住院时间相似（加巴喷丁组为5.94天[四分位间距（IQR），4.08至8.04天]；安慰剂组为6.15天[IQR，4.22至8.97天]；风险比为1.07；95%置信区间为0.95至1.20；P = 0.26）。总体而言，384名参与者经历了一次或多次严重不良事件（加巴喷丁组596人中189人[31.7%]；安慰剂组599人中195人[32.6%]），不同手术专科之间存在一些差异。
在接受心脏、胸部和腹部大手术的患者中，在多模式镇痛方案中添加加巴喷丁并未改变住院时间或严重不良事件的数量。
