Gabapentin: Perspective on Its Use as a Postoperative Analgesic by Colorectal Providers

Gabapentin (Gb) is increasingly used in postoperative pain management largely to reduce opioid use but without a strong evidence base. There is no literature available to understand why and how surgeons use gabapentin. We surveyed 85 NESCRS (New England Society of Colon and Rectal Surgeons) members by email (August-October 2024). Of the 32 responses (38% response rate), 28 were included: 68% were colorectal surgeons, 18% were advanced practice providers, 39% were female, 46% were aged 31-50 years, and 68% were White. Commonly prescribed analgesics were opioids (96%), acetaminophen (93%), nonsteroidal anti-inflammatory drugs (68%), and Gb (57%). Providers believed Gb reduced opioid use (75%), provided analgesia (54%), and decreased ileus (39%), length of stay (21%), and delirium (4%). Experienced providers more often reported that Gb's benefits outweighed its risks (69%), reduced postoperative opioid use (46%), or that they were confident in managing Gb-related adverse effects (38%), compared with 63, 18, or 27%, respectively (p-value=1.00,0.21, or 0.67). Overall, colorectal providers acknowledge Gb's potential benefits and associated risks as a postoperative analgesic.