The Preoperative Use of Gabapentinoids for the Treatment of Acute Postoperative Pain Following Lumbar Spine Fixation Surgery.

BACKGROUND

Postoperative pain following posterior fixation is caused not only by tissue injury during surgery and is related to inflammatory, neuropathic, and visceral pain. This study aims to answer the question, "Is there a role for gabapentinoids in reducing postoperative pain?" In addition, it demonstrates which gabapentinoids may be used, for how long, and at what dose.

METHODS

The study was planned as a prospective, randomized, double-blind study. Lumbar posterior fixation was included and patients were divided into 9 groups. Gabapentinoids and a placebo were administered. Postoperative pain at hours 1, 6, 12, and 24 was evaluated by visual analog scale (VAS).

RESULTS

This study included 252 patients (141 women, 111 men). The median age was 51.62 years. A statistically significant difference was found when VAS-1, VAS-6, VAS-12, and VAS-24 scores were compared between all groups (P ˂ 0.001). Single and low doses of gabapentinoids were found to be ineffective (P > 0.05). Long-term and high-dose gabapentinoids had complications (P ˂ 0.001). Single and high doses of gabapentinoids were effective and safe (P ˂ 0.001).

CONCLUSIONS

Postoperative use of gabapentin for controlling early and late-stage pain is safe and effective. Single and high-dose gabapentin was the first choice. A single and high dose of pregabalin is the second choice.