Effect of Preoperative Oral Gabapentin on Postoperative Pain, Opioid Use, and Hospital Stay in Patients Undergoing Sleeve Gastrectomy: A Prospective Observational Study.

BACKGROUND

Effective postoperative pain management is a cornerstone of Enhanced Recovery After Surgery (ERAS) protocols, particularly in bariatric procedures such as sleeve gastrectomy. Uncontrolled pain can delay recovery, increase opioid use, and prolong hospital stay. Gabapentin, a gabapentinoid with analgesic and opioid-sparing properties, has shown promise as part of a multimodal analgesia regimen. This study evaluates the efficacy of preoperative oral gabapentin in improving postoperative outcomes in patients undergoing bariatric surgery.

METHODS

A prospective, non-randomized, blinded observational study was conducted on 50 patients undergoing laparoscopic sleeve gastrectomy. Each patient received a single dose of oral gabapentin (100-300 mg) four to six hours prior to surgery. Postoperative pain levels were assessed using the Visual Analog Scale (VAS) at regular intervals, and total opioid consumption was recorded in morphine-equivalent units. Duration of hospital stay and incidence of opioid-related side effects were also documented.

RESULTS

Patients who received gabapentin preoperatively reported significantly lower VAS scores in the immediate postoperative period (p < 0.05). Total opioid requirements were reduced by approximately 33% compared to historical controls. Additionally, patients demonstrated earlier mobilization and were discharged approximately 0.5 day earlier on average. Fewer opioid-related adverse events, such as nausea, vomiting, and drowsiness, were observed in the gabapentin group.

DISCUSSION: These findings support current National Institute for Health and Care Excellence (NICE) guidelines and ERAS recommendations, which advocate for multimodal, opioid-sparing approaches in perioperative care. Incorporating gabapentin preoperatively may enhance recovery, minimize complications, and improve overall patient outcomes following sleeve gastrectomy.

CONCLUSION

Preoperative oral gabapentin appears to be a safe and effective adjunct for improving postoperative pain control in bariatric surgery. Its use was associated with reduced opioid consumption, improved patient comfort, and shorter hospital stay-factors that align with the goals of ERAS.