Effects of gabapentin on postoperative pain management after spinal surgery: a systematic review and meta-analysis

Abstract

Effective postoperative pain management is pivotal for recovery, with an increasing focus on non-opioid analgesics. This study evaluates the efficacy of gabapentin in reducing postoperative opioid usage and pain after spinal surgeries in adults. We conducted a meta-analysis of prospective randomized placebo- controlled trials comparing preoperative gabapentin with placebo in adult spinal surgery patients. Primary outcomes included opioid consumption in the first 24 hours postoperatively, converted to oral morphine equivalents. Secondary outcomes assessed were Visual Analog Scale (VAS) pain scores and side effects within the same period. Thirteen of 674 studies met inclusion criteria, encompassing 843 participants. Gabapentin significantly decreased opioid consumption (mean difference [MD]: -39.91, 95% CI: -66.40 to -13.41;p=0.0069) and reduced VAS pain scores at various postoperative intervals, despite high heterogeneity (I²=96.8%). Preoperative gabapentin reduces opioid consumption and early postoperative pain in spinal surgery patients. Further research is needed to ascertain the optimal dosing and potential impacts on postoperative complications.