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A2096
October 20, 2019
10/20/2019 7:45:00 AM - 10/20/2019 9:15:00 AM
Room W312AB
Perioperative Use of Gabapentinoids for the Management of Postoperative Acute Pain:a Systematic Review and Meta-analysis
Michael Verret, M.D., François Lauzier, M.D., M.S., Ryan Zarychanski, M.D., M.S., Caroline Perron, M.S., Xavier Savard, M.D., Anne-marie Pinard, M.D., Guillaume Leblanc, M.D., Marie-Joelle Cossi, Ph.D., Alexis F. Turgeon, M.D., M.S.
Centre de recherche du CHU de Québec-Université Laval, Québec, Quebec , Canada
Disclosures: M. Verret: None.F. Lauzier: None.R. Zarychanski: None.C. Perron: None.X. Savard: None.A. Pinard: None.G. Leblanc: None.M. Cossi: None.A.F. Turgeon: None.
Background: Gabapentinoids are frequently used in the perioperative period to reduce pain and opioid use, however, evidence to inform best practice is unclear.

Methods: We conducted a systematic review and meta-analysis of randomized controlled trials comparing the use of gabapentinoids in adult patients undergoing surgery (PROSPERO-CRD42017067029). We searched Medline, EMBASE, CENTRAL, Web of Science and ClinicalTrials.gov databases from inception to January 2018. Our primary outcome was the intensity of postoperative pain 12 hours after surgery (any quantitative scale; minimally important difference [MID] of 10 on 100-point scale). Our secondary outcomes included opioids use, intensity of postoperative pain at other time points, lengths of stay, incidence of postoperative chronic pain and adverse events. We pooled mean differences (MD) and risk ratios (RR) using random effects models.

Results: We identified 6795 citations from which we included 281 trials (n=24 682 participants); 67 at low risk of bias. Gabapentinoids were associated with a decrease in pain intensity at 12 hours (MD, -8.79/100 [95%CI, -10.27 to -7.31]; 130 trials), and opioids use at 24 hours (MD, -7.90 mg of intravenous morphine equivalent [95%CI, -8.82 to -6.98]; 117 trials). We observed no clinically significant effect on other outcomes and an increased risk of adverse events.

Conclusions: We observed no clinically significant analgesic effect for the perioperative use of gabapentinoids, with low level of evidence, and an increased risk of adverse events with moderate level of evidence. Our results do not support the use of gabapentinoids for the management postoperative acute pain in adult patients.

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