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Gabapentinoids (gabapentin and pregabalin) are prescribed widely for perioperative pain management, in part to reduce opioid use after surgery. Now, Canadian researchers have published a meta-analysis of 281 randomized trials that involved 25,000 patients among whom perioperative gabapentinoids (started between 1 week before and 12 hours after surgery) were compared with placebo, other analgesics, or usual care. Half the trials involved orthopedic, spinal, and abdominal surgeries; a broad array of other surgeries accounted for the other half. Gabapentin and pregabalin were each studied in roughly half the trials.
At several time points during the 72 postoperative hours, pain scores were statistically significantly lower in gabapentinoid reci…