AAOS2017: Narcotic-sparing effect noted with gabapentin use in total knee arthroplasty

Study Type: Randomized Trial
OE Level of Evidence: N/A
Journal Level of Evidence: N/A
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Synopsis
50 patients scheduled for total knee arthroplasty were randomized to either perioperative gabapentin or placebo administration. Patients were assessed on postoperative days 0, 1, and 2 for pain scores on a visual analog scale, narcotic consumption, and knee range of motion. Results demonstrated no Please login to view the rest of this report. Please login to view the rest of this report.
Why was this study needed now?
A number of recent randomized controlled trials have been conducted on the possible efficacy of gabapentinoids, such as gabapentin, in postoperative analgesic management following total knee arthroplasty. However, results from these studies have been inconsistent. This study sought to evaluate the efficacy of perioperative gabapentin for postoperative analgesia in total knee arthroplasty.
What was the principal research question?
In total knee arthroplasty, does perioperative gabapentin significantly reduce postoperative pain scores and narcotic consumption when compared to placebo when assessed over postoperative days 0, 1, and 2?
Population: 50 patients scheduled for total knee arthroplasty
Intervention: Gabapentin group: Patients were administered gabapentin 600mg preoperatively, and gabapentin 300mg postoperatively at 8-hour intervals for the first three days. (n=25; 20 analyzed)
Comparison: Placebo group: Patients were administered placebo preoperatively, and placebo postoperatively at 8-hour intervals for the first three days. (n=25; 17 analyzed)
Outcomes: Outcomes included pain on a visual analog scale, total narcotic consumption in morphine equivalents, knee range of motion, and subjective assessment of feeling either "rested" or "tired" postoperatively.
Methods: RCT
Time: Outcomes were assessed on postoperative days (POD) 0 (ie. day of surgery), 1, and 2.
What were the important findings?
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The authors responsible for this critical appraisal and ACE Report indicate no potential conflicts of interest relating to the content in the original publication.