Gabapentin May Not Decrease Opioid Use in Pediatric Enhanced Recovery After Surgery Protocols

Area of Science:

• Anesthesiology
• Pediatric Surgery
• Pharmacology

Background:

• Gabapentin use in adult Enhanced Recovery After Surgery (ERAS) protocols is linked to higher morbidity and minimal pain relief.
• Limited data exists on gabapentin's efficacy and safety in pediatric ERAS protocols.

Purpose of the Study:

• To investigate the association between gabapentin administration and postoperative outcomes in children undergoing elective surgery.
• To evaluate gabapentin's impact on opioid consumption and other clinical outcomes within pediatric ERAS protocols.

Main Methods:

• Retrospective study of 196 pediatric patients undergoing elective general, urologic, or orthopedic surgery.
• Comparison of patients who received gabapentin versus those who did not, including univariate, multivariable, and propensity score-matched analyses.
• Data collected from January 2018 to September 2021, after gabapentin was removed from institutional ERAS protocols.

Main Results:

• Gabapentin did not correlate with reduced opioid consumption when combined with opioids.
• Children receiving gabapentin showed higher odds of requiring oxygen supplementation, though this was not significant after propensity score matching.
• No significant association found between gabapentin use and decreased postoperative narcotic use.

Conclusions:

• Gabapentin in multimodal pediatric pain regimens did not decrease postoperative opioid use.
• Further prospective studies are recommended to assess gabapentin's role in pediatric perioperative pain management.
• The utility of gabapentin in pediatric ERAS protocols requires additional investigation.