Gabapentin side effects after surgery

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Gabapentin Side Effects After Surgery: Key Findings

Increased Risk of Delirium, Pneumonia, and Antipsychotic Use in Older Adults

In older adults (65+), using gabapentin after major surgery is linked to a higher risk of delirium, new antipsychotic medication use, and pneumonia compared to those not given gabapentin. The risk of delirium is especially higher in patients with more health problems or chronic kidney disease. However, gabapentin use did not increase the risk of in-hospital death in this group .

Common Adverse Effects: Dizziness, Visual Disturbance, and Sedation

Across adult surgical patients, gabapentin and similar drugs (gabapentinoids) are associated with more dizziness and visual disturbances after surgery. Sedation is also more common in patients who receive gabapentin compared to those who do not 235. These side effects are generally mild but can be concerning, especially in vulnerable populations.

Postoperative Nausea and Vomiting (PONV): Mixed Results

Gabapentin can reduce the risk of postoperative nausea and vomiting in some surgical settings, particularly when given before surgery. However, in certain groups, such as bariatric surgery patients, gabapentin did not significantly change the rates of nausea, vomiting, or other side effects like dizziness and headache 34510.

Opioid-Sparing Effects and Other Side Effects

Gabapentin is often used to reduce the need for opioids after surgery, which can help lower opioid-related side effects like vomiting, pruritus (itching), and urinary retention. Studies in spinal and abdominal surgeries show that gabapentin can reduce these opioid-related side effects, but it may increase the risk of sedation 5678910.

Pediatric and Bariatric Surgery: Limited Data on Side Effects

In children and bariatric surgery patients, gabapentin appears to reduce pain and opioid use without a clear increase in side effects like dizziness, headache, or somnolence. However, the data in these groups are limited, and more research is needed to fully understand the risk profile 46.

Conclusion

Gabapentin after surgery can help reduce pain and the need for opioids, but it is associated with side effects such as dizziness, visual disturbances, and sedation. In older adults, there is a notable increase in the risk of delirium, pneumonia, and new antipsychotic use. While gabapentin may lower the risk of postoperative nausea and vomiting in some cases, its overall benefit must be weighed against these potential risks, especially in vulnerable populations. Careful patient selection and monitoring are recommended when considering gabapentin for postoperative pain management 12345678+2 MORE.

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Most relevant research papers on this topic

Perioperative Gabapentin Use and In-Hospital Adverse Clinical Events Among Older Adults After Major Surgery.

Perioperative gabapentin use in older patients undergoing major surgery is associated with increased risk of delirium, new antipsychotic use, and pneumonia, but no difference in in-hospital death.

Observational StudyRigorous Journal

2022·

55citations

·Chan Mi Park et al.

Perioperative Use of Gabapentinoids for the Management of Postoperative Acute Pain: A Systematic Review and Meta-analysis.

Perioperative use of pregabalin or gabapentinoids for postoperative pain management in adult patients showed no significant analgesic effect and increased the risk of adverse events.

Meta-AnalysisHighly Cited

2020·

270citations

·Michael Verret et al.

The Effect of Preoperative Gabapentin on Postoperative Nausea and Vomiting: A Meta-Analysis

Preoperative gabapentin significantly reduces postoperative nausea and vomiting, making it a valuable tool in preventing these side effects in patients undergoing general anesthesia.

Meta-AnalysisRigorous Journal

2016·

42citations

·M. Grant et al.

Efficacy and Safety of Gabapentin on Postoperative Pain Management After Bariatric Surgery: A Systematic Review and Meta-Analysis.

Gabapentin effectively reduces postoperative pain and morphine consumption in bariatric surgery patients, but limited data exists on its opioid-sparing effect and adverse effect profiles.

Meta-Analysis

2022·

7citations

·Tito D. Tubog et al.

A systematic review and meta‐regression analysis of prophylactic gabapentin for postoperative pain

Prophylactic gabapentin reduces postoperative pain, reduces morphine consumption, and increases patient satisfaction, but its effects may be overestimated due to small study effects.

Meta-AnalysisRigorous JournalHighly Cited

2015·

151citations

·B. Doleman et al.

The Effects of Gabapentin on Post-Operative Pain and Anxiety, Morphine Consumption and Patient Satisfaction in Paediatric Patients Following the Ravitch Procedure—A Randomised, Double-Blind, Placebo-Controlled, Phase 4 Trial

Pre- and postoperative gabapentin administration may decrease postoperative pain, opioid consumption, and demand for a "rescue drug" in pediatric patients undergoing the modified Ravitch procedure, while improving patient satisfaction.

RCTRigorous Journal

2022·

10citations

·Dariusz Fenikowski et al.

Analgesic Effects of Gabapentin after Spinal Surgery

Preoperative oral gabapentin significantly reduces early postoperative pain and morphine consumption in spinal surgery patients, while also reducing some morphine-associated side effects.

RCTHighly Cited

2004·

271citations

·A. Turan et al.

The effects of gabapentin on acute and chronic postoperative pain after coronary artery bypass graft surgery.

Gabapentin significantly reduces acute postoperative pain and tramadol consumption after CABG surgery, with no significant difference in pain scores at 1 and 3 months post-surgery.

RCTHighly Cited

2011·

101citations

·A. Uçak et al.

The Efficacy of Preoperative Gabapentin in Spinal Surgery: A Meta-Analysis of Randomized Controlled Trials.

Preoperative gabapentin effectively reduces postoperative opioid consumption, visual analog scale scores, and some side effects after spinal surgery.

Meta-Analysis

2017·

41citations

·Chao Han et al.

The Role of Gabapentin in Enhanced Recovery After Surgery (ERAS) for Patients Undergoing Abdominal Procedures, A Systematic Review and Meta‐Analysis

Gabapentin effectively reduces postoperative pain, opioid consumption, and postoperative nausea and vomiting in patients undergoing abdominal surgery.

Meta-Analysis

2025·

0citations

·Y. Molla et al.

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