A systematic review and meta-regression analysis of prophylactic gabapentin for postoperative pain

We searched MEDLINE, Embase, CINAHL, AMED and CENTRAL databases until December 2014 and included 133 randomised controlled trials of peri-operative gabapentin vs placebo. Gabapentin reduced mean (95% CI) 24-h morphine-equivalent consumption by 8.44 (7.26–9.62) mg, p < 0.001, whereas more specific...

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Main Authors: Doleman, Brett, Heinink, T.P., Faleiro, R.J., Lund, Jonathan N., Williams, John P.
Format: Article
Published: Wiley 2015
Online Access:https://eprints.nottingham.ac.uk/40245/
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author Doleman, Brett
Heinink, T.P.
Faleiro, R.J.
Lund, Jonathan N.
Williams, John P.
author_facet Doleman, Brett
Heinink, T.P.
Faleiro, R.J.
Lund, Jonathan N.
Williams, John P.
author_sort Doleman, Brett
building Nottingham Research Data Repository
collection Online Access
description We searched MEDLINE, Embase, CINAHL, AMED and CENTRAL databases until December 2014 and included 133 randomised controlled trials of peri-operative gabapentin vs placebo. Gabapentin reduced mean (95% CI) 24-h morphine-equivalent consumption by 8.44 (7.26–9.62) mg, p < 0.001, whereas more specific reductions in morphine equivalents were predicted (R2 = 90%, p < 0.001) by the meta-regression equation: 3.73 + (−0.378 × control morphine consumption (mg)) + (−0.0023 × gabapentin dose (mg)) + (−1.917 × anaesthetic type), where ‘anaesthetic type’ is ‘1’ for general anaesthesia and ‘0’ for spinal anaesthesia. The type of surgery was not independently associated with gabapentin effect. Gabapentin reduced postoperative pain scores on a 10-point scale at 1 h, 2 h, 6 h, 12 h and 24 h by a mean (95% CI) of: 1.68 (1.35–2.01); 1.21 (0.88–1.55); 1.28 (0.98–1.57); 1.12 (0.91–1.33); and 0.71 (0.56–0.87), respectively, p < 0.001 for all. The risk ratios (95% CI) for postoperative nausea, vomiting, pruritus and sedation with gabapentin were: 0.78 (0.69–0.87), 0.67 (0.59–0.76), 0.64 (0.51–0.80) and 1.18 (1.09–1.28), respectively, p < 0.001 for all. Gabapentin reduced pre-operative anxiety and increased patient satisfaction on a 10-point scale by a mean (95% CI) of 1.52 (0.78–2.26) points and 0.89 (0.22–1.57) points, p < 0.001 and p = 0.01, respectively. All the effects of gabapentin may have been overestimated by statistically significant small study effects.
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spelling nottingham-402452020-05-04T17:17:05Z https://eprints.nottingham.ac.uk/40245/ A systematic review and meta-regression analysis of prophylactic gabapentin for postoperative pain Doleman, Brett Heinink, T.P. Faleiro, R.J. Lund, Jonathan N. Williams, John P. We searched MEDLINE, Embase, CINAHL, AMED and CENTRAL databases until December 2014 and included 133 randomised controlled trials of peri-operative gabapentin vs placebo. Gabapentin reduced mean (95% CI) 24-h morphine-equivalent consumption by 8.44 (7.26–9.62) mg, p < 0.001, whereas more specific reductions in morphine equivalents were predicted (R2 = 90%, p < 0.001) by the meta-regression equation: 3.73 + (−0.378 × control morphine consumption (mg)) + (−0.0023 × gabapentin dose (mg)) + (−1.917 × anaesthetic type), where ‘anaesthetic type’ is ‘1’ for general anaesthesia and ‘0’ for spinal anaesthesia. The type of surgery was not independently associated with gabapentin effect. Gabapentin reduced postoperative pain scores on a 10-point scale at 1 h, 2 h, 6 h, 12 h and 24 h by a mean (95% CI) of: 1.68 (1.35–2.01); 1.21 (0.88–1.55); 1.28 (0.98–1.57); 1.12 (0.91–1.33); and 0.71 (0.56–0.87), respectively, p < 0.001 for all. The risk ratios (95% CI) for postoperative nausea, vomiting, pruritus and sedation with gabapentin were: 0.78 (0.69–0.87), 0.67 (0.59–0.76), 0.64 (0.51–0.80) and 1.18 (1.09–1.28), respectively, p < 0.001 for all. Gabapentin reduced pre-operative anxiety and increased patient satisfaction on a 10-point scale by a mean (95% CI) of 1.52 (0.78–2.26) points and 0.89 (0.22–1.57) points, p < 0.001 and p = 0.01, respectively. All the effects of gabapentin may have been overestimated by statistically significant small study effects. Wiley 2015-09-15 Article PeerReviewed Doleman, Brett, Heinink, T.P., Faleiro, R.J., Lund, Jonathan N. and Williams, John P. (2015) A systematic review and meta-regression analysis of prophylactic gabapentin for postoperative pain. Anaesthesia, 70 (10). pp. 1186-1204. ISSN 1365-2044 http://onlinelibrary.wiley.com/doi/10.1111/anae.13179/abstract doi:10.1111/anae.13179 doi:10.1111/anae.13179
spellingShingle Doleman, Brett
Heinink, T.P.
Faleiro, R.J.
Lund, Jonathan N.
Williams, John P.
A systematic review and meta-regression analysis of prophylactic gabapentin for postoperative pain
title A systematic review and meta-regression analysis of prophylactic gabapentin for postoperative pain
title_full A systematic review and meta-regression analysis of prophylactic gabapentin for postoperative pain
title_fullStr A systematic review and meta-regression analysis of prophylactic gabapentin for postoperative pain
title_full_unstemmed A systematic review and meta-regression analysis of prophylactic gabapentin for postoperative pain
title_short A systematic review and meta-regression analysis of prophylactic gabapentin for postoperative pain
title_sort systematic review and meta-regression analysis of prophylactic gabapentin for postoperative pain
url https://eprints.nottingham.ac.uk/40245/
https://eprints.nottingham.ac.uk/40245/
https://eprints.nottingham.ac.uk/40245/