Faculty Collaboration Database

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

Date

04/27/2010

Pubmed ID

20418301

DOI

10.1213/ANE.0b013e3181d41dc2

Scopus ID

2-s2.0-77951751967 (requires institutional sign-in at Scopus site)   113 Citations

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.

Author List

Rusy LM, Hainsworth KR, Nelson TJ, Czarnecki ML, Tassone JC, Thometz JG, Lyon RM, Berens RJ, Weisman SJ

Authors

Richard J. Berens MD Professor in the Anesthesiology department at Medical College of Wisconsin
Keri Hainsworth PhD Associate Professor in the Anesthesiology department at Medical College of Wisconsin
Roger M. Lyon MD Adjunct Professor in the Orthopaedic Surgery department at Medical College of Wisconsin
Lynn M. Rusy MD Professor in the Anesthesiology department at Medical College of Wisconsin
J Channing Tassone MD Professor in the Orthopaedic Surgery department at Medical College of Wisconsin
John G. Thometz MD Professor in the Orthopaedic Surgery department at Medical College of Wisconsin
Steven J. Weisman MD Professor in the Anesthesiology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Acute Disease
Adolescent
Amines
Analgesia, Patient-Controlled
Analgesics
Analgesics, Opioid
Child
Cyclohexanecarboxylic Acids
Double-Blind Method
Female
Humans
Male
Morphine
Pain Measurement
Pain, Postoperative
Postoperative Nausea and Vomiting
Scoliosis
Spinal Fusion
Treatment Outcome
gamma-Aminobutyric Acid