Ľadministration préopératoire de gabapentine pour ľanalgésie postopératoire: une méta-analyse

Regional Anesthesia and Pain

Résumé

Objectif

Le rôle de la gabapentine dans le traitement de la douleur neuropathique chronique est bien connu. Ce qui l'esľt moins, c’est son rôle dans le traitement de la douleur postopératoire. Pour le vérifier, nous avons fait une méta-analyse de toutes les études randomisées qui ont abordé le rôle de la gabapentine dans le contrôle de la douleur postopératoire aiguë. Nous avons surtout cherché si la gabapentine réduit les scores de douleur, la consommation ďanalgésique et/ou les effets secondaires reliés à ľanalgésie des 24 premières heures postopératoires.

Source

Nous avons repéré huit études randomisées, contrôlées contre placebo et mené une méta-analyse en utilisant les principaux paramètres des scores de douleur, consommation totale ďanalgésique et effets secondaires pendant 24 h. Constatations principales : Les patients qui ont reçu de la gabapentine préopératoire ont présenté des scores de douleur (-11,9 au repos et -11,0 au mouvement sur une échelle visuelle analogique de 100 points) et une consommation ďopioïdes (-14,7 mg de morphine en 24 h) significativement plus faibles, mais une incidence ďeffets secondaires similaire.

Conclusion

Quoique la gabapentine donnée avant ľopération diminue les scores de douleur et la consommation ďanalgésique pendant les 24 premières heures postopératoires, la portée clinique de ce résultat reste indéterminée. Cette méta-analyse ne peut démontrer de réduction significative ďincidence des effets secondaires. Étant donné les petits échantillons étudiés, de plus grandes études randomisées et contrôlées sont nécessaires.

Preoperative gabapentin for postoperative analgesia: a meta-analysis

Abstract

Purpose

Gabapentin’s role in the treatment of chronic neuropathic pain is well known. What is less well established is its role for managing postoperative pain. In order to clarify whether gabapentin’s utility in acute pain control is more than just theoretical, we conducted a meta-analysis of all randomized trials that addressed gabapentin’s role in acute postoperative pain control. We specifically addressed whether gabapentin reduces pain scores, analgesia consumption, and/or analgesia-related side effects in the first 24 hr following surgery.

Source

We identified eight placebo-controlled, randomized controlled trials and conducted a meta-analysis using the primary outcomes of pain scores, total analgesia consumption, and side effects over a 24-hr period.

Principle findings

Patients who received gabapentin preoperatively reported significantly lower pain scores (-11.9 at rest and -11.0 with movement on a 100-point visual analogue scale) and opioid consumption (-14.7 mg of morphine in 24 hr) with no difference in the incidence of side effects.

Conclusion

Although gabapentin given preoperatively decreases pain scores and analgesic consumption in the first 24 hr after surgery, the clinical significance of this finding has yet to be determined. This meta-analysis could not demonstrate a significant reduction in the incidence of side effects. Due to the small numbers enrolled in the studies, larger randomized control trials are warranted.

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Copyright information

© Canadian Anesthesiologists 2006

Authors and Affiliations

  1. 1.From the School of Undergraduate MedicineCanada
  2. 2.Department of AnesthesiaMcMaster UniversityHamiltonCanada
  3. 3.DundasCanada

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