Gabapentin for Perioperative Analgesia in Otorhinolaryngology-Head and Neck Surgery: Systematic Review

Otolaryngol Head Neck Surg. 2016 Dec;155(6):893-903. doi: 10.1177/0194599816659042. Epub 2016 Jul 26.

Abstract

Objective: Recent research has investigated the role of gabapentin in perioperative pain relief in otorhinolaryngology-head and neck surgery. This review aims to identify whether sufficient evidence exists for the routine use of gabapentin in the perioperative setting.

Data sources: MEDLINE, Cochrane CENTRAL, EMBASE, and Google Scholar.

Review methods: A comprehensive systematic search was performed with keywords for articles up to November 2015. The systematic review included all randomized, placebo-, and active-controlled trials investigating the role of perioperative gabapentin for pain in otorhinolaryngology-head and neck surgery. The studies were assessed for risk of bias and selected and reviewed by the main author. Selected trials were required to have data in the form of pain intensity scores, analgesic consumption, adverse effects, or return to normal function.

Results: A total of 14 randomized controlled trials were included, of which 4 had an active control. The placebo-controlled trials included 4 for tonsillectomy, 3 for rhinology, and 3 for thyroidectomy. These studies were not suitable for meta-analysis. Trial quality involving gabapentin in tonsillectomy surgery is variable. The higher-quality studies reported significantly reduced analgesic consumption in the gabapentin groups, with the effect on pain scores less clear. There was a significant benefit, within the first 24 hours, in pain and analgesic consumption as compared with placebo favoring the gabapentin groups following rhinologic and thyroid surgery.

Conclusion: Overall, gabapentin appears to have a significant beneficial effect on perioperative pain relief and analgesic consumption in otorhinolaryngology-head and neck surgery procedures within the first 24 hours.

Keywords: gabapentin; otolaryngology; perioperative pain; rhinoplasty; septoplasty; sinus surgery; thyroidectomy; tonsillectomy.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Amines / therapeutic use*
  • Analgesia* / methods
  • Analgesics / therapeutic use*
  • Cyclohexanecarboxylic Acids / therapeutic use*
  • Evidence-Based Medicine
  • Gabapentin
  • Head and Neck Neoplasms / surgery*
  • Humans
  • Otolaryngology*
  • Otorhinolaryngologic Surgical Procedures* / methods
  • Pain Measurement
  • Perioperative Care / methods*
  • Randomized Controlled Trials as Topic
  • Treatment Outcome
  • gamma-Aminobutyric Acid / therapeutic use*

Substances

  • Amines
  • Analgesics
  • Cyclohexanecarboxylic Acids
  • gamma-Aminobutyric Acid
  • Gabapentin