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Analgesic Efficacy of Gabapentin and Pregabalin in Patients Undergoing Laparoscopic Bariatric Surgeries: a Systematic Review and Meta-analysis

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Abstract

This meta-analysis investigated the effect of oral gabapentinoids (i.e., pregabalin and gabapentin) on analgesic consumption (i.e., primary outcome) and pain relief (i.e., secondary outcome) in patients following bariatric surgery. Analysis of five eligible trials published between 2010 and 2019 including 363 participants receiving gabapentinoids revealed a significantly lower morphine consumption [mean difference (MD) =  − 15.1 mg, p = 0.004; evidence certainty: low] and risk of nausea/vomiting [risk ratio (RR) = 0.49, p = 0.002; evidence certainty: high] at postoperative 6–24 h. There was also a lower pain score at postoperative 0–4 h (MD =  − 1.41, p < 0.00001; evidence certainty: low) and 6–12 h (MD =  − 0.9, p = 0.007; evidence certainty: low) compared with controls, while pain severity at postoperative 24 h was comparable between two groups. In summary, preoperative oral gabapentinoids optimized postoperative pain outcomes and reduced risk of nausea/vomiting following bariatric surgery.

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Contributions

Conceptualization and literature search: KCH and SCW; methodology: MHC; trial selection: CWH and JYC.; data analysis: PWH; data extraction: SCW and CWH; writing—original draft preparation: KCH, JYC, and CKS; writing—review and editing: KCH and CKS. All authors have read and agreed to the published version of the manuscript.

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Correspondence to Cheuk-Kwan Sun.

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Key Points

• Oral gabapentinoid effects on post-bariatric surgery (BS) analgesic use and pain.

• Potential adverse sedative effect in immediate postoperative period remains unclear.

• There were lower opioid consumption and nausea/vomiting risk at post-BS 6–24 h.

• Oral gabapentinoids were also associated with lower pain scores at postoperative 0–4 h.

• No difference in pain severity was noted at postoperative 24 h compared with controls.

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Hung, KC., Wu, SC., Chiang, MH. et al. Analgesic Efficacy of Gabapentin and Pregabalin in Patients Undergoing Laparoscopic Bariatric Surgeries: a Systematic Review and Meta-analysis. OBES SURG 32, 2734–2743 (2022). https://doi.org/10.1007/s11695-022-06109-6

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