Purpose
To evaluate the efficacy of perioperative gabapentin or pregabalin treatment on postoperative
pain and opioid requirement reduction in patients undergoing anterior cruciate ligament
reconstruction (ACLR).
Methods
A systematic review of randomized control trials was conducted evaluating the effect
of gabapentin or pregabalin on postoperative pain and opioid requirement for patients
undergoing ACLR. The primary outcomes assessed were postoperative pain scores and
opioid requirements. Secondary outcomes were complications, side effects, dosage,
and timing of intervention.
Results
The initial search query identified 151 studies and 6 studies were included after
full-text articles were reviewed. Three studies investigated the use of gabapentin
and three studies investigated pregabalin. All three gabapentin studies reported significantly
decreased or equivalent pain scores while also significantly reducing or removing
total opioid consumption compared to control groups. Pregabalin demonstrated inconsistent
efficacy for pain control and opioid consumption parameters across three studies.
One study (pregabalin, n = 1) reported significantly increased incidence of dizziness with pregabalin compared
to placebo.
Conclusion
There is moderate evidence demonstrating that preoperative gabapentin may be safe
and effective in reducing postoperative pain and opioid consumption after ACLR. Gabapentin
may be considered when employed as part of a multimodal analgesia regimen; however,
the optimal protocol has yet to be determined. Currently, there is limited evidence
demonstrating the efficacy of pregabalin on pain and opioid consumption in the setting
of ACLR.
Level of Evidence
Systematic Review of Level I Studies
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Article info
Publication history
Published online: December 07, 2022
Accepted:
November 11,
2022
Received:
May 23,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
The authors report the following potential conflicts of interest or sources of funding: R.F.L. reports royalties from Arthrex and Smith & Nephew; consulting fees from Ossur, Smith & Nephew, and Arthex, research support from Arthrex, Linvatec, Ossur, and Smith & Nephew, editorial/governing board membership for AJSM and KSSTA, and membership/committee appointments in AOSSM, ISAKOS, AANA, and ESSKA. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Identification
Copyright
© 2023 Published by Elsevier on behalf of the Arthroscopy Association of North America
