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Gabapentin use in pediatric spinal fusion patients: a randomized, double-blind, controlled trial.
Anesth Analg. 2010 May 01; 110(5):1393-8.A&A

Abstract

BACKGROUND

Gabapentin has opioid-sparing effects in adult surgical patients, but no reported studies have involved children and adolescents. In a double-blind, randomized, controlled trial, we examined whether gabapentin decreases postoperative opioid consumption for pediatric spinal fusion patients with idiopathic scoliosis.

METHODS

Patients, aged 9 to 18 years, received preoperative gabapentin (15 mg/kg, treatment) or placebo. Anesthesia was standardized. After surgery, all patients received standardized patient-controlled analgesia opioid and continued on either gabapentin (5 mg/kg) or placebo 3 times per day for 5 days. Opioid use was calculated in mg/kg/time intervals. Pain scores and opioid side effects were recorded.

RESULTS

Data from 59 patients (30 placebo and 29 gabapentin) did not differ in demographics. Total morphine consumption (mg/kg/h +/- SD) was significantly lower in the gabapentin group in the recovery room (0.044 +/- 0.017 vs 0.064 +/- 0.031, P = 0.003), postoperative day 1 (0.046 +/- 0.016 vs 0.055 +/- 0.017, P = 0.051), and postoperative day 2 (0.036 +/- 0.016 vs 0.047 +/- 0.019, P = 0.018). In addition, gabapentin significantly reduced first pain scores in the recovery room (2.5 +/- 2.8 vs 6.0 +/- 2.4, P < 0.001) and the morning after surgery (3.2 +/- 2.6 vs 5.0 +/- 2.2, P < 0.05), but otherwise pain scores were not significantly different. There were no differences in opioid-related side effects over the course of the study.

CONCLUSION

Perioperative oral gabapentin reduced the amount of morphine used for postoperative pain after spinal fusion surgery, but not overall opioid-related side effects. Initial pain scores were lower in the treatment group. Perioperative use of gabapentin seems to be an effective adjunct to improve pain control in the early stages of recovery in children and adolescents undergoing spinal fusion.

Authors+Show Affiliations

Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI, USA. lrusy@mcw.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20418301

Citation

Rusy, Lynn M., et al. "Gabapentin Use in Pediatric Spinal Fusion Patients: a Randomized, Double-blind, Controlled Trial." Anesthesia and Analgesia, vol. 110, no. 5, 2010, pp. 1393-8.
Rusy LM, Hainsworth KR, Nelson TJ, et al. Gabapentin use in pediatric spinal fusion patients: a randomized, double-blind, controlled trial. Anesth Analg. 2010;110(5):1393-8.
Rusy, L. M., Hainsworth, K. R., Nelson, T. J., Czarnecki, M. L., Tassone, J. C., Thometz, J. G., Lyon, R. M., Berens, R. J., & Weisman, S. J. (2010). Gabapentin use in pediatric spinal fusion patients: a randomized, double-blind, controlled trial. Anesthesia and Analgesia, 110(5), 1393-8. https://doi.org/10.1213/ANE.0b013e3181d41dc2
Rusy LM, et al. Gabapentin Use in Pediatric Spinal Fusion Patients: a Randomized, Double-blind, Controlled Trial. Anesth Analg. 2010 May 1;110(5):1393-8. PubMed PMID: 20418301.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Gabapentin use in pediatric spinal fusion patients: a randomized, double-blind, controlled trial. AU - Rusy,Lynn M, AU - Hainsworth,Keri R, AU - Nelson,Tom J, AU - Czarnecki,Michelle L, AU - Tassone,J Channing, AU - Thometz,John G, AU - Lyon,Roger M, AU - Berens,Richard J, AU - Weisman,Steven J, PY - 2010/4/27/entrez PY - 2010/4/27/pubmed PY - 2010/5/14/medline SP - 1393 EP - 8 JF - Anesthesia and analgesia JO - Anesth Analg VL - 110 IS - 5 N2 - BACKGROUND: Gabapentin has opioid-sparing effects in adult surgical patients, but no reported studies have involved children and adolescents. In a double-blind, randomized, controlled trial, we examined whether gabapentin decreases postoperative opioid consumption for pediatric spinal fusion patients with idiopathic scoliosis. METHODS: Patients, aged 9 to 18 years, received preoperative gabapentin (15 mg/kg, treatment) or placebo. Anesthesia was standardized. After surgery, all patients received standardized patient-controlled analgesia opioid and continued on either gabapentin (5 mg/kg) or placebo 3 times per day for 5 days. Opioid use was calculated in mg/kg/time intervals. Pain scores and opioid side effects were recorded. RESULTS: Data from 59 patients (30 placebo and 29 gabapentin) did not differ in demographics. Total morphine consumption (mg/kg/h +/- SD) was significantly lower in the gabapentin group in the recovery room (0.044 +/- 0.017 vs 0.064 +/- 0.031, P = 0.003), postoperative day 1 (0.046 +/- 0.016 vs 0.055 +/- 0.017, P = 0.051), and postoperative day 2 (0.036 +/- 0.016 vs 0.047 +/- 0.019, P = 0.018). In addition, gabapentin significantly reduced first pain scores in the recovery room (2.5 +/- 2.8 vs 6.0 +/- 2.4, P < 0.001) and the morning after surgery (3.2 +/- 2.6 vs 5.0 +/- 2.2, P < 0.05), but otherwise pain scores were not significantly different. There were no differences in opioid-related side effects over the course of the study. CONCLUSION: Perioperative oral gabapentin reduced the amount of morphine used for postoperative pain after spinal fusion surgery, but not overall opioid-related side effects. Initial pain scores were lower in the treatment group. Perioperative use of gabapentin seems to be an effective adjunct to improve pain control in the early stages of recovery in children and adolescents undergoing spinal fusion. SN - 1526-7598 UR - https://www.unboundmedicine.com/medline/citation/20418301/Gabapentin_use_in_pediatric_spinal_fusion_patients:_a_randomized_double_blind_controlled_trial_ L2 - https://doi.org/10.1213/ANE.0b013e3181d41dc2 DB - PRIME DP - Unbound Medicine ER -