• Spine · Oct 2013

    Review Meta Analysis

    Gabapentin and pregabalin in the management of postoperative pain after lumbar spinal surgery: a systematic review and meta-analysis.

    • Lin Yu, Bo Ran, Min Li, and Zhicai Shi.
    • *Department of Orthopedics, The People's Liberation Army General Hospital of Chengdu Command, Chengdu, Sichuan Province, People's Republic of China; and †Department of Orthopedics, Changhai Hospital, Shanghai, People's Republic of China.
    • Spine. 2013 Oct 15; 38 (22): 1947-52.

    Study DesignSystematic review and meta-analysis.ObjectiveTo review the literature systematically and make a comprehensive understanding of the efficacy of these 2 drugs in the management of postoperative pain after lumbar spinal surgery.Summary Of Background DataSeveral trials that evaluated the efficacy of gabapentin and pregabalin in the management of postoperative pain after lumbar spinal surgery have been published.MethodsPubMed (1980 to present), adapted for EMBASE (1980 to present), and Cochrane databases were searched for randomized placebo-controlled trials. Random effect model was used in our meta-analysis, and standard mean difference (SMD) was chosen as the pooled estimate.ResultsSeven trials were included in our study. All included studies could be considered to be of high quality in methodology. The pooled results from meta-analysis demonstrated that compared with placebo, both gabapentin and pregabalin could significantly reduce the postoperative narcotic consumption (SMD, -1.54, and -1.16, respectively). Oral gabapentin was efficacious in the management of postoperative pain at all time points during the first day after surgery (SMD, -1.91 at 0-6 hr, -1.30 at 6-12 hr, -1.05 at 12-24 hr, respectively). Pregabalin seemed to be also efficacious in the management of postoperative pain at 0 to 6 hours (SMD, -1.05), at 6 to 12 hours (SMD, -0.62), and at 12 to 24 hours (SMD, -0.43). Both drugs could be well tolerated in our included trials, compared with placebo.ConclusionThis work suggested that both gabapentin and pregabalin were efficacious in reduction of postoperative pain and narcotic requirements after lumbar spinal surgery, whereas more trials were needed to further assess the efficacy of pregabalin in the management of postoperative pain after lumbar spinal surgery.Level Of Evidence1.

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