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Child's Nervous System

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07-09-2023 | Rhizotomy | Original Article

Gabapentin as part of a multimodal pain protocol for selective dorsal rhizotomy does not impact percentage of rootlets transected

Authors: Mary E. Lynch, David J. Daniels, Joline E. Brandenburg

Published in: Child's Nervous System | Issue 2/2024

Abstract

Purpose

We aim to determine whether preoperatively initiated gabapentin for pain control impacts the percentage of rootlets cut during monitored, limited laminectomy selective dorsal rhizotomy (SDR) procedure.

Methods

This retrospective cohort study includes participants with cerebral palsy who had SDR for treatment of spasticity between 2010 and 2019 at a single-institution tertiary care center. One-level laminectomy SDR aimed to evaluate the cauda equina roots from levels L2-S1 with EMG monitoring. Gabapentin titration began 3 weeks prior to SDR. Data was analyzed using simple linear regression. Thirty-one individuals met inclusion criteria. Mean age was 7 years, 4 months. Eighteen participants (58%) identified as male, 12 (39%) female, and one (3%) non-binary. Thirty (97%) had bilateral CP. Sixteen (52%) were GMFCS II, four (13%) GMFCS III, five (16%) GMFCS IV, and six (19%) GMFCS V.

Results

Mean percentage of rootlets transected was 50.75% (SD 6.00, range 36.36–60.87). There was no relationship between the dose of gabapentin at time of SDR and percentage of rootlets cut with a linear regression slope of − 0.090 and an R² of 0.012 (P = 0.56).

Conclusion

Results indicate that preoperative initiation of gabapentin did not impact the percentage of rootlets transected. Thus, gabapentin can be initiated prior to SDR at moderate dosages without impacting SDR surgical outcomes.

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Title: Gabapentin as part of a multimodal pain protocol for selective dorsal rhizotomy does not impact percentage of rootlets transected
Authors: Mary E. Lynch
David J. Daniels
Joline E. Brandenburg
Publication date: 07-09-2023
Publisher: Springer Berlin Heidelberg
Keywords: Rhizotomy
Gabapentin
Opioids
Opioids
Published in: Child's Nervous System / Issue 2/2024
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI: https://doi.org/10.1007/s00381-023-06124-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Gabapentin as part of a multimodal pain protocol for selective dorsal rhizotomy does not impact percentage of rootlets transected

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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