Gabapentin for post‐operative pain management – a systematic review with meta‐analyses and trial sequential analyses

Abstract

O. (2016). Gabapentin for postoperative pain management-a systematic review with meta-analyses and trial sequential analyses. This article included Trial Sequential Analyses (TSA) of the random-effects models used to adjust the confidence intervals (CI) for possible sparse data and repetitive testing. Unfortunately, due to a bug in the TSA program, the required information size (RIS) for continuous outcomes were calculated twice the correct value. There was no error in the calculations of RIS for dichotomous outcomes. However, even with an upgrade of the GRADE evaluation of the effect on the co-primary outcome of 24 hrs morphine consumption from 'very low' to 'low' the conclusions still hold and should not be changed. Accordingly, the authors present corrections for the following passages in the article: In the Abstract, Results section:

Chronic Opioid Use After Surgery: Implications for Perioperative Management in the Face of the Opioid Epidemic

“…101,102,105 In contrast, a meta-analysis of 9498 patients found a negligible reduction in 24–hour morphine consumption with use of gabapentin, with an even more diminished effect in the context of multimodal analgesia. 106 These findings were limited by low quality evidence due to small study sizes and inconsistency. 106 Studies examining the utility of perioperative gabapentin for remote postoperative opioid cessation are needed to fully understand the utility of gabapentin alone or as part of multimodal analgesia protocols.…”

“…106 These findings were limited by low quality evidence due to small study sizes and inconsistency. 106 Studies examining the utility of perioperative gabapentin for remote postoperative opioid cessation are needed to fully understand the utility of gabapentin alone or as part of multimodal analgesia protocols.…”

Coadyuvantes farmacológicos con efecto ahorrador de opioides en el periodo perioperatorio

“…Aunque se usa comúnmente para el tratamiento del dolor neuropático crónico, la evidencia contemporánea parece apoyar su uso en el tratamiento del dolor posquirúrgico agudo. Mientras que los metanálisis previos indican que la administración perioperatoria de gabapentina se asocia con una disminución significativa en el uso de opioides postoperatorios, el grado de esta disminución puede haberse sobreestimado, como sugieren los estudios recientes que se basaron en análisis de estudios con bajo riesgo de sesgo o meta regresión en su análisis (20,21).…”

Gabapentin in procedure-specific postoperative pain management – preplanned subgroup analyses from a systematic review with meta-analyses and trial sequential analyses

“…In a recent systematic review we pooled data from all clinical trials and different surgical interventions with gabapentin [12, 13]. The conclusion from this review was, that firm evidence for use of gabapentin is lacking, as clinically relevant beneficial effects of gabapentin may be absent and harm is imminent, especially when added to multimodal analgesic regimens [12].…”

“…The conclusion from this review was, that firm evidence for use of gabapentin is lacking, as clinically relevant beneficial effects of gabapentin may be absent and harm is imminent, especially when added to multimodal analgesic regimens [12]. In the present preplanned subgroup analyses and post hoc analyses, we aimed to compare the procedure-specific effects of peri-operative gabapentin on postoperative opioid consumption, pain intensity, and adverse- and serious adverse events in six different surgical procedures.…”