Preoperative Gabapentin for Vaginal Prolapse Procedures: A Randomized Trial.

Area of Science:

• Gynecologic surgery
• Anesthesiology
• Pharmacology

Background:

• Enhanced Recovery After Surgery (ERAS) protocols often include perioperative gabapentin.
• Evidence for gabapentin's efficacy in vaginal prolapse procedures is limited.

Purpose of the Study:

• To evaluate the effect of preoperative gabapentin on postoperative opioid consumption.
• To assess pain control and recovery outcomes in patients undergoing vaginal apical suspension for pelvic organ prolapse.

Main Methods:

• A double-blind, randomized, placebo-controlled trial.
• Participants received gabapentin (300 mg) or placebo 1 hour pre-surgery, with acetaminophen and celecoxib.
• Primary outcome: 24-hour postoperative opioid use (morphine milligram equivalents).

Main Results:

• No significant difference in 24-hour opioid use between gabapentin and placebo groups (P=0.15).
• Secondary outcomes including pain scores and time to discharge were also not significantly different.
• Regression and per-protocol analyses confirmed these findings.

Conclusions:

• A single preoperative dose of gabapentin did not reduce opioid use or improve pain control.
• Gabapentin demonstrated limited utility in this specific surgical context.
• Findings question the routine use of gabapentin in ERAS protocols for vaginal apical suspension.