Gabapentin for Postoperative Pain Control and Opioid Reduction in Scrotal Surgery: A Randomized Controlled Clinical Trial

J Urol. 2024 May;211(5):658-666. doi: 10.1097/JU.0000000000003884. Epub 2024 Feb 21.

Abstract

Purpose: To assess the safety and efficacy of gabapentin in reducing postoperative pain among patients undergoing scrotal surgery for male infertility by conducting a randomized, double-blind, placebo-controlled trial.

Materials and methods: In this randomized, double-blind, placebo-controlled trial, healthy men undergoing scrotal surgery with a single surgeon were randomized to receive either (1) gabapentin 600 mg given 2 hours preoperatively and 300 mg taken 3 times a day postoperatively for 3 days, or (2) inactive placebo. The primary outcome measure was difference in postoperative pain scores. Secondary outcomes included differences in opioid usage, patient satisfaction, and adverse events.

Results: Of 97 patients screened, 74 enrolled and underwent randomization. Of these, 4 men were lost to follow-up, and 70 were included in the final analysis (35 gabapentin, 35 placebo). Both differences in initial postoperative mean pain score (-1.14, 95% CI -2.21 to -0.08, P = .035) and final mean pain score differences (-1.27, 95% CI -2.23 to -0.32, P = .0097) indicated lower gabapentin pain compared to placebo. There were no statistically significant differences in opioid usage, patient satisfaction, or adverse events.

Conclusions: These data suggest that perioperative gabapentin results in a statistically and clinically significant decrease in pain following scrotal surgery. While there was no evidence of an impact on opioid usage or patient satisfaction, given the low risk of adverse events, it may be considered as part of a multimodal pain management strategy.

Keywords: analgesics; gabapentin; microsurgery; opioid; scrotum.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Analgesics* / therapeutic use
  • Analgesics, Opioid* / adverse effects
  • Double-Blind Method
  • Gabapentin / therapeutic use
  • Humans
  • Male
  • Pain Management / methods
  • Pain, Postoperative / drug therapy
  • Pain, Postoperative / etiology
  • Pain, Postoperative / prevention & control

Substances

  • Gabapentin
  • Analgesics, Opioid
  • Analgesics