We reviewed thirteen high quality prospective randomized controlled trials that represented the best available evidence to assess the efficacy of gabapentinoids in reducing postoperative pain and opioid consumption after TJA.
Gabapentin did not have any impact on postoperative pain in the perioperative period at all time points after TJA compared to placebo in the seven high quality studies included. Five studies specifically evaluated pain scores within 3 days postoperatively and found there was no difference in pain scores between patients treated with gabapentin and patients treated with placebo.
Pregabalin reduced opioid consumption, but did not show a consistently significant impact on postoperative pain compared to placebo in the perioperative period after primary TJA. Of the six studies included, five studies evaluated pain scores within 3 days postoperatively. Three of these studies found no difference in pain scores between placebo and pregabalin, while two studies found pregabalin reduced pain compared to placebo.
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