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Does Gabapentin affect Pain Control and Functional Outcome after Total Knee Arthroplasty? A Prospective, Randomized, Double-blind Placebo Control Trial Texas Orthopaedic Journal

Abstract

Introduction: Gabapentin has been used successfully for perioperative pain control in orthopedic, general, cardiothoracic, breast, and spine surgeries. The goal of this study was to determine if perioperative gabapentin reduced postoperative pain and narcotics consumption in patients undergoing total knee arthroplasty (TKA). The purposes of this study were to determine whether 1) gabapentin affected pain control in TKA, and 2) gabapentin affected functional outcomes in TKA.

Methods: Fifty patients were randomized to receive either 600 mg gabapentin or a placebo preoperatively, and either 300 mg gabapentin or placebo postoperatively every 8 hours for 3 days. Postoperatively, patients were asked to rate their pain on the visual analogue scale (VAS) twice daily, narcotics consumption was recorded each day, and patients were asked whether they felt rested or tired upon waking. Knee range of motion (ROM) was recorded twice daily. Narcotics consumption was recorded as morphine dose equivalents (MDE).

Results: Patients in the gabapentin group had significantly lower narcotics consumption than the placebo group on postoperative days 1 and 2 (p=0.014, p=0.037). The groups did not show a significant difference between narcotics consumption on postoperative day 0 (p=0.136). There were no significant differences in pain VAS scores, knee ROM, or feeling rested versus tired at any time points.

Discussion: Perioperative use of gabapentin significantly reduces narcotics consumption on postoperative days 1 and 2 after primary, unilateral TKA. Perioperative use of gabapentin had no significant effect on narcotics consumption on postoperative day 0. Perioperative use of gabapentin had no significant effect at any time point on pain VAS score, knee ROM, and restfulness.

Author List

Winkler C, Beicker C, Wooldridge AN, Larumbe E, Caroom C, Swinford N, Jenkins M, Brindley GW.

Author

Adam Neal Wooldridge MD, MPH Assistant Professor in the Orthopaedic Surgery department at Medical College of Wisconsin


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