Background

Gabapentin (GAB) is known to be effective in reducing postoperative pain but may have adverse side-effects, including postoperative dizziness and prolonged sedation. We have investigated the effect of GAB on postoperative time-to-alertness, incidence of dizziness, pain relief and opioid consumption in patients following totally robotic (TR)-RYGB.

Methods

The study included 50 patients on GAB and 50 who were not (NO-GAB) who were matched for age, BMI, gender, and health status. Patients on GAB received 600 mg preoperatively, 300 mg TID on the hospital unit, and 300 mg at discharge. Measurements were: 1) postoperative time-to-alertness, 2) incidence of disorientation/dizziness, 3) surgery outcomes (operative times, LOS, complications), 4) average pain scores and opioid usage in the postoperative ambulatory care unit (PACU) and over the first 24 h of the hospital stay.

Results

Surgical outcomes were similar between the GAB vs. NO-GAB patients for LOS, complications, and time in PACU. There were also no significant differences in postoperative time-to-alertness (199.0 vs. 210.4 min) and, with GAB, only one case of postoperative dizziness. Average pain scores for GAB and NO-GAB patients while in the PACU did not differ (1.7+-0.23 vs. 2.0+-0.32) but opioid needs with GAB were significantly less (2.34+-0.43 vs. 4.09+-0.47 mEq, p=0.0073). Average 24-h pain scores with GAB on the hospital unit were significantly (p=0.0006) lower than NO-GAB (3.34+-0.17 vs. 4.20+-0.17, respectively), and 24-hr opioid needs were clinically (62%) and significantly less (4.64+-0.99 vs.7.50+-1.0 mEq).

Conclusions

GAB is effective in reducing pain and opioid needs with few adverse effects following TR-RYGB.