Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Journal of Orthopaedic Surgery and Research
Published in: Journal of Orthopaedic Surgery and Research 1/2016

Open Access 01-12-2016 | Review

The use of gabapentin in the management of postoperative pain after total hip arthroplasty: a meta-analysis of randomised controlled trials

Authors: Chao Han, Xiao-dan Li, Hong-qiang Jiang, Jian-xiong Ma, Xin-long Ma

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2016

Login to get access

Abstract

Background

Pain management after total hip arthroplasty (THA) varies and has been widely studied in recent years. Gabapentin as a third-generation antiepileptic drug that selectively affects the nociceptive process has been used for pain relief after THA. This meta-analysis was conducted to examine the efficacy of gabapentin in THA.

Methods

An electronic-based search was conducted using the following databases: PubMed, EMBASE, Ovid MEDLINE, ClinicalTrials.gov, and Cochrane Central Register of Controlled Trials (CENTRAL). Randomised controlled trials (RCTs) involving gabapentin and a placebo for THA were included. The meta-analysis was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.

Results

Five trials met the inclusion criteria. The cumulative narcotic consumption and the visual analogue scale (VAS) scores at 24 and 48 h postoperatively were used for postoperative pain assessment. There was a significant decrease in morphine consumption at 24 h (P = 0.00). Compared with the control group, the VAS score (at rest) at 48 h was less in the gabapentin group (P = 0.00).

Conclusion

The administration of gabapentin is effective in decreasing postoperative narcotic consumption and the VAS score.
Literature
1.
Murphy TP, Byrne DP, Curtin P, Baker JF, Mulhall KJ. Can a periarticular levobupivacaine injection reduce postoperative opiate consumption during primary hip arthroplasty? Clin Orthop Relat Res. 2012;470(4):1151–57.CrossRefPubMed
2.
Apfelbaum JL, Chen C, Mehta SS, Gan TJ. Postoperative pain experience: results from a national survey suggest postoperative pain continues to be undermanaged. Anesth Analg. 2003;97(2):534–40.CrossRefPubMed
3.
Buvanendran A, Kroin JS. Multimodal analgesia for controlling acute postoperative pain. Curr Opin Anaesthesiol. 2009;22(5):588–93.CrossRefPubMed
4.
Andersen LO, Gaarn-Larsen L, Kristensen BB, Husted H, Otte KS, Kehlet H. Subacute pain and function after fast-track hip and knee arthroplasty. Anaesthesia. 2009;64(5):508–13.CrossRefPubMed
5.
Lewis GN, Rice DA, McNair PJ, Kluger M. Predictors of persistent pain after total knee arthroplasty: a systematic review and meta-analysis. Br J Anaesth. 2015;114(4):551–61.CrossRefPubMed
6.
Dias AS, Rinaldi T, Barbosa LG. The impact of patients controlled analgesia undergoing orthopedic surgery. Braz J Anesthesiol. 2016;66(3):265–71.CrossRefPubMed
7.
Pandazi A, Kanellopoulos I, Kalimeris K, Batistaki C, Nikolakopoulos N, Matsota P, Babis GC, Kostopanagiotou G. Periarticular infiltration for pain relief after total hip arthroplasty: a comparison with epidural and PCA analgesia. Arch Orthop Trauma Surg. 2013;133(11):1607–12.CrossRefPubMed
8.
Melzack R, Abbott FV, Zackon W, Mulder DS, Davis MW. Pain on a surgical ward: a survey of the duration and intensity of pain and the effectiveness of medication. Pain. 1987;29(1):67–72.CrossRefPubMed
9.
Rose MA, Kam PC. Gabapentin: pharmacology and its use in pain management. Anaesthesia. 2002;57(5):451–62.CrossRefPubMed
10.
Chouinard G, Beauclair L, Belanger MC. Gabapentin: long-term antianxiety and hypnotic effects in psychiatric patients with comorbid anxiety-related disorders. Can J Psychiatr Rev Can Psychiatr. 1998;43(3):305.
11.
Ajori L, Nazari L, Mazloomfard MM, Amiri Z. Effects of gabapentin on postoperative pain, nausea and vomiting after abdominal hysterectomy: a double blind randomized clinical trial. Arch Gynecol Obstet. 2012;285(3):677–82.CrossRefPubMed
12.
Yu L, Ran B, Li M, Shi Z. Gabapentin and pregabalin in the management of postoperative pain after lumbar spinal surgery: a systematic review and meta-analysis. Spine. 2013;38(22):1947–52.CrossRefPubMed
13.
Hwang SH, Park IJ, Cho YJ, Jeong YM, Kang JM. The efficacy of gabapentin/pregabalin in improving pain after tonsillectomy: a meta-analysis. Laryngoscope.2016;126(2):357–66.
14.
15.
Moher D, Liberati A, Tetzlaff J, Altman DG, Group P. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. J Clin Epidemiol. 2009;62(10):1006–12.CrossRefPubMed
16.
Higgins JP, Altman DG, Gotzsche PC, Juni P, Moher D, Oxman AD, Savovic J, Schulz KF, Weeks L, Sterne JA, et al. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ. 2011;343:d5928.CrossRefPubMedPubMedCentral
17.
Clarke H, Kay J, Mitsakakis N, Katz J. Acute pain after total hip arthroplasty does not predict the development of chronic postsurgical pain 6 months later. J Anesth. 2010;24(4):537–43.CrossRefPubMed
18.
Clarke H, Kay J, Orser BA, Gollish J, Mitsakakis N, Katz J. Gabapentin does not reduce preoperative anxiety when given prior to total hip arthroplasty. Pain Med (Malden, Mass). 2010;11(6):966–71.CrossRef
19.
Clarke H, Pereira S, Kennedy D, Andrion J, Mitsakakis N, Gollish J, Katz J, Kay J. Adding gabapentin to a multimodal regimen does not reduce acute pain, opioid consumption or chronic pain after total hip arthroplasty. Acta Anaesthesiol Scand. 2009;53(8):1073–83.CrossRefPubMed
20.
Nantha-Aree M, Paul J, Buckley N, Shahzad U, Cheng J, Thabane L, Tidy A. Gabapentin does not improve analgesia for total hip arthroplasty. Can J Anesth. 2011;58:S149.CrossRef
21.
Paul JE, Nantha-Aree M, Buckley N, Shahzad U, Cheng J, Thabane L, Tidy A, DeBeer J, Winemaker M, Wismer D, et al. Randomized controlled trial of gabapentin as an adjunct to perioperative analgesia in total hip arthroplasty patients. Can J Anaesth. 2015;62(5):476–84.CrossRefPubMed
22.
Straube S, Derry S, Moore RA, Wiffen PJ, McQuay HJ. Single dose oral gabapentin for established acute postoperative pain in adults. Cochrane Database Syst Rev. 2010;5:CD008183.PubMed
23.
Ho KY, Gan TJ, Habib AS. Gabapentin and postoperative pain—a systematic review of randomized controlled trials. Pain. 2006;126(1-3):91–01.CrossRefPubMed
24.
Alayed N, Alghanaim N, Tan X, Tulandi T. Preemptive use of gabapentin in abdominal hysterectomy: a systematic review and meta-analysis. Obstet Gynecol. 2014;123(6):1221–29.CrossRefPubMed
25.
Doleman B, Heinink TP, Read DJ, Faleiro RJ, Lund JN, Williams JP. A systematic review and meta-regression analysis of prophylactic gabapentin for postoperative pain. Anaesthesia. 2015;70(10):1186–04.CrossRefPubMed
26.
Pandey CK, Navkar DV, Giri PJ, Raza M, Behari S, Singh RB, Singh U, Singh PK. Evaluation of the optimal preemptive dose of gabapentin for postoperative pain relief after lumbar diskectomy: a randomized, double-blind, placebo-controlled study. J Neurosurg Anesthesiol. 2005;17(2):65–8.CrossRefPubMed
27.
Khan ZH, Rahimi M, Makarem J, Khan RH. Optimal dose of pre-incision/post-incision gabapentin for pain relief following lumbar laminectomy: a randomized study. Acta Anaesthesiol Scand. 2011;55(3):306–12.CrossRefPubMed
Metadata
Title
The use of gabapentin in the management of postoperative pain after total hip arthroplasty: a meta-analysis of randomised controlled trials
Authors
Chao Han
Xiao-dan Li
Hong-qiang Jiang
Jian-xiong Ma
Xin-long Ma
Publication date
01-12-2016
Publisher
BioMed Central
Published in
Journal of Orthopaedic Surgery and Research / Issue 1/2016
Electronic ISSN: 1749-799X
DOI
https://doi.org/10.1186/s13018-016-0412-z

Other articles of this Issue 1/2016

Journal of Orthopaedic Surgery and Research 1/2016 Go to the issue

Research article

Quantification of cephalomedullary nail fit in the femur using 3D computer modelling: a comparison between 1.0 and 1.5m bow designs

Research article

Overgrowth of the femoral neck after hip fractures in children

Research article

Effectiveness of the surgical torque limiter: a model comparing drill- and hand-based screw insertion into locking plates

Research article

Expression of adiponectin receptors in human and rat intervertebral disc cells and changes in receptor expression during disc degeneration using a rat tail temporary static compression model

Research article

Analysis of the independent risk factors of neurologic deficit after thoracolumbar burst fracture

Technical note

The importance of reaming the posterior femoral cortex before inserting lengthening nails and calculation of the amount of reaming