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Gabapentin: Perspective on Its Use as a Postoperative Analgesic by Colorectal Providers.
Manjia Zhao1, Joao Filipe G Monteiro2, Matthew Vrees3
1Brown School of Public Health, Providence Rhode Island.
Rhode Island Medical Journal (2013)
|September 26, 2025
Summary
Colorectal surgeons commonly prescribe gabapentin (Gb) for postoperative pain, believing it reduces opioid use and offers analgesia. However, evidence supporting these benefits is limited, highlighting a gap in understanding its clinical application.
Area of Science:
- Surgical Pain Management
- Pharmacology
- Evidence-Based Medicine
Background:
- Gabapentin (Gb) is frequently used in postoperative pain management, primarily to decrease opioid consumption.
- The evidence base supporting gabapentin's efficacy in this context is not robust.
- There is a lack of literature detailing the rationale and methods behind surgeons' use of gabapentin.
Purpose of the Study:
- To investigate the prescribing patterns and perceived benefits of gabapentin in postoperative pain management among colorectal surgeons.
- To understand the reasons why and how surgeons utilize gabapentin in clinical practice.
- To assess the awareness of potential benefits and risks associated with gabapentin use.
Main Methods:
- A survey was distributed via email to 85 members of the New England Society of Colon and Rectal Surgeons (NESCRS) between August and October 2024.
- A total of 32 responses were received, with 28 included in the final analysis.
- The survey collected data on demographics, commonly prescribed analgesics, and perceived effects of gabapentin.
Main Results:
- Gabapentin was prescribed by 57% of respondents, with opioids (96%), acetaminophen (93%), and NSAIDs (68%) also commonly used.
- Providers believed gabapentin reduced opioid use (75%), provided analgesia (54%), and decreased ileus (39%), length of stay (21%), and delirium (4%).
- Experienced providers were more likely to report that gabapentin's benefits outweighed its risks (69%) and that they were confident in managing adverse effects (38%).
Conclusions:
- Colorectal providers acknowledge the potential benefits of gabapentin as a postoperative analgesic, including opioid-sparing effects.
- Despite limited evidence, gabapentin is widely prescribed, suggesting a perceived clinical utility.
- Further research is warranted to establish a stronger evidence base for gabapentin's role in postoperative pain management and to address potential risks.
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