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Increasingly, surgeons are prescribing gabapentin or pregabalin to prevent or relieve postoperative pain, with the intent of limiting postoperative opioid use. However, evidence to support this strategy is mixed, and several reports have suggested that gabapentinoids might confer excess risk for postoperative respiratory depression. U.S. researchers used the Premier hospital database to examine whether perioperative gabapentinoid use was associated with pulmonary complications in 858,000 patients who underwent elective total hip or total knee arthroplasty between 2009 and 2014; 11% of patients received gabapentin, and 10% received pregabalin.
In analyses adjusted for numerous potentially confounding variables, perioperative use of gabapentin…