Exploring the effects of preoperative gabapentin on postoperative pain and opioid consumption in patients undergoing orthopedic surgery under spinal anesthesia

Background: Central neuronal sensitization plays a key role in postoperative pain. Gabapentin, known for its opioid-sparing and analgesic properties, may help prevent sensitization when administered preemptively with minimal adverse effects. Aim: This study aims to assess the effectiveness of preoperative gabapentin (neurontin) in pain relief, its potential to reduce opioid consumption, its effects on anxiety and sedation, and any associated adverse effects. Materials and Methods: A total of 80 American Society of Anesthesiologists grade I and II patients undergoing orthopedic surgery were randomly assigned to two groups. Group A received 400 mg of gabapentin, while Group B received 800 mg, both administered 2 h before surgery. Postoperative evaluations over 24 h included pain scores, tramadol consumption, rescue analgesia requirements, sedation levels, and adverse effects. Results: Group B had a cumulative pain score of 10 compared to 15 in Group A ( P < 0.0001). The mean tramadol consumption at 24 h postoperatively was 297 mg in Group A and 212 mg in Group B ( P < 0.0001). Group B also experienced a significantly longer duration of analgesia (6.73 h vs. 2.68 h in Group A, P < 0.0001). No significant adverse effects were observed in either group. Conclusion: The preoperative administration of gabapentin appears to be an effective strategy for enhancing postoperative pain control and reducing opioid use in orthopedic patients undergoing spinal anesthesia. Further studies are necessary to determine the optimal dosing regimen and long-term effects of gabapentin in this setting.