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Gabapentin as a novel adjunct for postoperative irritability after superior cavopulmonary connection operation in

Celine Thibault1,2,3, E Zachary Ramsey4, Hailey Collier4

  • 1Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia, PA, USA.

Cardiology in the Young
|May 3, 2024
PubMed

Insights

Off-label gabapentin use for irritability after superior cavopulmonary connection surgery showed increased frequency. While it modestly reduced benzodiazepine needs, gabapentin did not impact opioid requirements in infants.

Area of Science:

  • Pediatric Cardiology
  • Cardiac Surgery
  • Pharmacology

Background:

  • Superior cavopulmonary connection (SCPC) surgery is a complex procedure in pediatric cardiac care.
  • Postoperative irritability is a common concern in infants following SCPC surgery.
  • Current management of postoperative irritability often involves opioids and benzodiazepines, carrying potential risks.

Purpose of the Study:

  • To evaluate the off-label use of gabapentin for managing irritability in infants post-SCPC surgery.
  • To assess the impact of gabapentin on the need for opioids and benzodiazepines.
  • To identify trends in gabapentin administration over time.

Main Methods:

  • A single-center retrospective cohort study was conducted.
  • Infants undergoing SCPC surgery between 2011 and 2019 were included.
  • Data on gabapentin administration, opioid, and benzodiazepine requirements were analyzed.

Main Results:

  • Gabapentin was administered to 22.9% of infants, with increasing use from 2015-2019.
  • Gabapentin use was associated with younger age at surgery and longer intensive care and hospital stays.
  • Infants receiving gabapentin showed reduced benzodiazepine exposure but no change in opioid exposure.

Conclusions:

  • Gabapentin use for postoperative irritability after SCPC surgery is increasing.
  • Gabapentin may offer a modest benefit in reducing benzodiazepine requirements.
  • Further investigation via a randomized controlled trial is recommended to confirm gabapentin's efficacy in this population.
Abstract

Keywords:
Glenncardiac surgerycongenital heart diseasepainpostoperative careuniventricular heart

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