Does the addition of post-operative gabapentin reduce the use of narcotics after orthopedic surgery?

ABSTRACT

Objectives

To evaluate the efficacy of post-operative gabapentin administration as an analgesic agent and its effect on narcotic use after orthopedic surgery in an outpatient sports medicine practice by comparing patients prior to and after initiating the routine use of gabapentin as part of a standardized post-operative pain medication regimen. We hypothesized that adding gabapentin to a multimodal post-operative pain regimen would decrease the number of requested pain medication refills and have no detrimental effect on Visual Analogue Scale and Single Assessment Numerical Evaluation scores at these early post-operative visits.

Methods

All outpatient surgical patients, <90 years of age, undergoing outpatient orthopedic surgery by the study’s senior author were included between 08/05/2021 and 02/22/2022. Patients were allowed 1 narcotic refill post-operatively and only in the first 3 weeks. The primary outcome was difference in percentage of patients who requested a narcotic refill within 3 weeks post-op. Two- and 6-week Visual Analogue Scale and Single Assessment Numerical Evaluation scores, and baseline health and demographic data. T-tests were run on continuous variables, Chi-Square or Fisher’s Exact Test were run on dichotomous variables, and Mann–Whitney U test was run on all other categorical variables. Statistical significance was set at P < .05 for all tests.

Results

There was a significant difference in narcotic refills at 3 weeks: 23 pre-gabapentin patients and 9 post-gabapentin patients (22.8% vs 9.0%, respectively: P = .006). There were no differences between 2- and 6-week Visual Analogue Scale and 2-week Single Assessment Numerical Evaluation scores. There was a significant difference in 6-week SANE between groups: mean difference = 6.4 (P = .027) though less than the established MCID.

Conclusion

Addition of gabapentin to a post-operative multimodal pain regimen reduced the use of narcotics after orthopedic sports medicine surgeries while also providing equivalent pain control.

KEYWORDS:

• gabapentin
• narcotic use
• opioids
• pain control
• sports medicine

G eolocation I nformation

SSM Health Saint Louis University Hospital, 1201 S Grand Blvd, St. Louis, MO 63,104

38°37’26” N, 90°14’15” W

Acknowledgements

The authors would like to acknowledge Allison Gruender for help in the preparation of the IRB and RBR protocols used for the present study and Saint Louis University School of Medicine Department of Orthopedic Surgery Chair, Dr Howard Place, for his general support of the study.

Disclosure statement

The authors report no conflicts of interest.

Additional information

Funding

The author(s) report that there is no funding associated with the work featured in this article.