Preoperative gabapentin in patients undergoing primary total knee arthroplasty

Summary 

Background

Patients undergoing total knee arthroplasty usually receive a multimodal analgesic regimen including peripheral nerve blockade, but may still experience significant pain. This study examined whether preoperative gabapentin decreases acute postoperative pain and opioid consumption in this setting.

Methods

Retrospective chart review of single institution, hospital-based orthopaedic practice. Consecutive patients undergoing unilateral elective primary knee arthroplasty were evaluated for perioperative gabapentin use. Sixty-one consecutive patients received gabapentin; for each, an age- and gender-matched control was identified.

Results

Patients in both groups demonstrated similar demographics, all received lumbar plexus blockade. Catheters were removed on postoperative day 2 (95%). There were no differences in postoperative pain scores or opioid use between groups. Overall, median verbal pain scores (IQR) were 0(1), 0(3), 1(3) and 3(3) in the post-anaesthesia care unit and postoperative days 0, 1 and 2, respectively. Postoperative consumption of other analgesics was not different across groups. Patients in the gabapentin group received a single-injection sciatic nerve block less often than patients in the control group (77% vs. 94%, respectively; p<0.05).

Conclusions

Patients undergoing unilateral total knee arthroplasty experience low pain scores utilizing a multimodal analgesic regimen including continuous lumbar plexus blockade independent of gabapentin use.

Keywords: Acute pain, Anticonvulsant, Continuous peripheral nerve catheter, Multimodal analgesia, Perineural blockade, Postoperative pain