The objective of this systematic review was to evaluate the efficacy and tolerability of perioperative
gabapentin administration for the control of
acute postoperative pain. We searched Medline (1966-2006), the Cochrane Library (2006), Scopus, CINAHL and bibliographies from clinical trials and review articles. We included randomized controlled trials (RCTs) comparing
gabapentin with inactive controls in surgical patients. Sixteen valid RCTs were included. Weighted mean difference (WMD) for
postoperative pain intensity (0-100 mm visual analogue scale) was -16.55 mm at 6 h and -10.87 mm at 24 h for treatment with a single preoperative dose of
gabapentin 1200 mg. Cumulative
opioid consumption at 24 h was also significantly decreased with
gabapentin (WMD, -27.90 mg). When
gabapentin was administered at doses less than 1200 mg,
pain intensity was also lower at 6 h (WMD, -22.43 mm) and 24 h (WMD, -13.18 mm). Cumulative 24 h
opioid consumption was also lower (WMD, -7.25 mg).
Gabapentin was associated with an increased risk of sedation (Peto OR 3.86; 95% CI 2.50-5.94) but less
opioid-related side effects such as
vomiting (Peto OR 0.58; 95% CI 0.39-0.86) and
pruritus (Peto OR 0.27; 95% CI 0.10-0.74). In conclusion,
gabapentin has an
analgesic and
opioid-sparing effect in
acute postoperative pain management when used in conjunction with
opioids.