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Gabapentinoids in ERAS Protocols For Spine Surgery: A Systematic Review and Meta-Analysis
Richard Wang1, Avrohom Karp1, Kevin Clare1
1School of Medicine, New York Medical College.
Clinical Spine Surgery
|September 1, 2025
Summary
Enhanced Recovery after Surgery (ERAS) protocols for spine surgery using gabapentinoids may reduce hospital stays. Gabapentinoid use in ERAS showed comparable or improved side effect profiles versus placebo, with no adverse events noted in spine surgery literature.
Area of Science:
- Neurosurgery
- Anesthesiology
- Pharmacology
Background:
- Enhanced Recovery after Surgery (ERAS) protocols aim to optimize surgical outcomes.
- Gabapentinoids are often used in ERAS to manage pain and reduce opioid consumption.
- Concerns exist regarding gabapentinoid safety, especially when combined with opioids.
Purpose of the Study:
- To evaluate the safety and efficacy of gabapentinoids within ERAS protocols for spine surgery.
- To conduct a systematic review and meta-analysis of relevant studies.
Main Methods:
- Systematic review and meta-analysis of studies on ERAS spine surgery protocols.
- Searched PubMed using MeSH terms to identify relevant ERAS and gabapentinoid complication studies.
- Analyzed data from 3045 patients in ERAS comparison studies and 417 in gabapentinoid side effect studies.
Main Results:
- ERAS cohorts showed a significant decrease in length of stay (LOS) compared to traditional treatment (P<0.05).
- A significant reduction in nausea and vomiting was observed with 150 mg pregabalin compared to control (P<0.05).
- No significant differences in other side effects were found for various gabapentinoid doses compared to placebo.
Conclusions:
- ERAS protocols incorporating gabapentinoids may shorten hospital LOS for spine surgery patients.
- Gabapentinoid analgesia in ERAS appears to have a favorable side effect profile compared to placebo.
- No adverse events from combining gabapentinoids and opioids were identified in the examined spine surgery literature.
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