Exploring the Safety and Efficacy of Gabapentin Use In Perioperative Analgesia Protocols: An Integrative Review

Gabapentin is widely used in perioperative analgesic protocols. Many clinical studies supporting the safety and analgesic efficacy of gabapentin for postoperative pain have been published over the last two decades. Several studies, many recently, have questioned its effectiveness and safety for perioperative pain management in early recovery after surgery (ERAS) and non-ERAS protocols leading to the research question: Is the use of gabapentin in perioperative analgesic protocols efficacious and safe for all perioperative patients? An integrative review was performed to identify, analyze, and synthesize a carefully selected sample of the evidence surrounding the inclusion of gabapentin in perioperative pain management practice. Analysis of the literature showed that gabapentin was found to be effective and safe in multiple studies yet may not be an effective treatment to include in all opioid-free multimodal pain regimens for ERAS and non-ERAS surgical pathways. Instead, gabapentin appears safe and effective for some populations of surgical patients undergoing a variety of procedures, while for other populations the medication is less efficacious and potentially harmful because of its side effects, which include respiratory depression, ataxia, and sedation.