Effectiveness of gabapentin as a postoperative analgesic in children undergoing appendectomy

• Published in: Pediatric surgery international Vol. 34; no. 7; pp. 769 - 774
• Main Authors: Baxter, Katherine J., Hafling, Jennifer, Sterner, Jennifer, Patel, Adarsh U., Giannopoulos, Helen, Heiss, Kurt F., Raval, Mehul V.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.07.2018; Springer Nature B.V
• Subjects: Adolescent; Amines - administration & dosage; Analgesics; Analgesics, Non-Narcotic - administration & dosage; Appendectomy; Appendicitis; Appendicitis - surgery; Child; Cyclohexanecarboxylic Acids - administration & dosage; Female; Gabapentin; gamma-Aminobutyric Acid - administration & dosage; Humans; Male; Medicine; Medicine & Public Health; Narcotics; Original Article; Pain; Pain, Postoperative - drug therapy; Pediatric Surgery; Pediatrics; Postoperative period; Retrospective Studies; Surgery; Abdominal surgery; Appendectomy; Analgesic; Gabapentin; Opioid epidemic
• ISSN: 0179-0358; 1437-9813
• DOI: 10.1007/s00383-018-4274-9

Purpose Though gabapentin is increasingly used as a perioperative analgesic, data regarding effectiveness in children are limited. The purpose of this study was to evaluate gabapentin as a postoperative analgesic in children undergoing appendectomy. Methods A 12-month retrospective review of children undergoing appendectomy was performed at a two-hospital children’s institution. Patients receiving gabapentin (GP) were matched (1:2) with patients who did not receive gabapentin (NG) based on age, sex and appendicitis severity. Outcome measures included postoperative opioid use, pain scores, and revisits/readmissions. Results We matched 29 (33.3%) GP patients with 58 (66.6%) NG patients ( n  = 87). The GP group required significantly less postoperative opioids than the NG group (0.034 mg morphine equivalents/kg (ME/kg) vs. 0.106 ME/kg, p  < 0.01). Groups had similar lengths of time from operation to pain scores ≤ 3 (GP 12.21 vs. NG 17.01 h, p  = 0.23). GP and NG had similar rates of revisit to the emergency department (13.8 vs. 10.3%, p  = 0.73), readmission (6.9 vs. 1.7%, p  = 0.26), and revisits secondary to surgical pain (3.4 vs. 3.4%, p  = 1.00). Conclusion In this single-center, retrospective cohort study, gabapentin is associated with a reduction in total postoperative opioid use in children with appendicitis. While promising, further prospective validation of clinical effectiveness is needed.