Assessment of the impact of gabapentin on postoperative pain following shoulder open rotator cuff repair: a double-blind clinical trial

Background: Gabapentin is an anticonvulsant used for managing neuropathic pain. Its effectiveness and dosing strategies for postoperative pain, particularly in open shoulder rotator cuff repair, are still debated. This study assesses gabapentin's impact on postoperative pain intensity in open rotator cuff repair.

Methods: Sixty eligible patients were randomly distributed into 2 groups: placebo and gabapentin. The gabapentin group received a daily dose of 600 mg, administered in 2 divided increments, beginning 3 days before the surgery and continuing for 1 week postoperatively. Pain intensity, assessed via the Visual Analog Scale, was the primary endpoint during the first postoperative week. Secondary aims conducted on both groups included quantifying opioid consumption, evaluation of side effects attributed to gabapentin and opioids, assessment of sleep quality, and patients' satisfaction levels with the employed approach.

Result: Postoperative pain in the gabapentin group significantly decreased from the first 24 hours until the fourth day postsurgery (P < .002), accompanied by reduced opioid consumption (P = .02). Following discharge, the prevalence of nocturnal sleep disruptions and oxycodone consumption in the gabapentin group notably decreased compared to the placebo group, alongside a significant improvement in sleep quality and duration until the fifth day, as well as overall satisfaction with the pain management approach seen within the gabapentin group (P = .003).

Conclusion: Administering gabapentin perioperatively at 600 mg daily and divided over a minimum duration of 4 days postoperatively may significantly reduce postoperative pain intensity and opioid consumption in open shoulder rotator cuff repair surgery patients.