Key result
Preoperative gabapentin or intraoperative ketorolac did not decrease postoperative pain, while females had higher first PACU VAS pain scores than males (6.05 vs 5.15, P=0.0026).
Why the study?
Optimizing perioperative analgesia affects patient satisfaction and short-term outcomes, but the effect of preoperative gabapentin or intraoperative ketorolac following hip arthroscopy remains uncertain.
Does preoperative gabapentin or intraoperative ketorolac reduce postoperative pain or time to discharge in patients undergoing hip arthroscopy?
Cohort (n=409)
No
Does preoperative gabapentin or intraoperative ketorolac reduce postoperative pain or time to discharge in patients undergoing hip arthroscopy?
Preoperative gabapentin and intraoperative ketorolac do not significantly improve postoperative pain scores or time to discharge following hip arthroscopy.
No association with reduced pain or faster discharge after hip arthroscopy; leaves open efficacy pending randomized confirmation.
Optimization of perioperative analgesia has important implications for patient satisfaction and short-term outcomes. This study’s purpose is to assess if preoperative gabapentin or intraoperative ketorolac influences postoperative pain or time to discharge following hip arthroscopy. In total, 409 patients who underwent hip arthroscopic femoroplasty and/or acetabuloplasty with a single surgeon for femoroacetabular impingement were retrospectively reviewed (September 2017 to February 2021). The effect of preoperative gabapentin or intraoperative ketorolac on postoperative visual analog scale (VAS) pain scores, perioperative opioids in morphine milligram equivalents (MMEs), time in post-anesthesia care unit (PACU), second-stage recovery and time to discharge was assessed using unadjusted and adjusted t-tests, and generalized linear models controlling for operative time, traction time, preoperative MME, intraoperative MME and postoperative MME were compared between the groups of gabapentin to no gabapentin and ketorolac to no ketorolac. There was no difference in first PACU VAS pain score, final PACU VAS score, VAS pain score prior to discharge, average VAS pain score or pain level on follow-up call in the unadjusted or adjusted analysis for the preoperative gabapentin or intraoperative ketorolac groups. Females had higher first PACU VAS pain score (6.05 versus 5.15 P = 0.0026), final PACU VAS pain score (4.43 versus 3.90, P = 0.0045), final VAS pain score prior to discharge (3.87 versus 3.03, P < 0.001) and average postoperative pain score (4.60 versus 4.03, P < 0.001), but no difference in VAS pain score on follow-up call following surgery. Gabapentin or ketorolac was not associated with decreased VAS pain scores or time to discharge after hip arthroscopy.
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Meyer et al. (2023) conducted a cohort in Femoroacetabular impingement (n=409). Preoperative gabapentin or intraoperative ketorolac vs. No gabapentin and no ketorolac was evaluated on Postoperative visual analog scale (VAS) pain scores, perioperative opioids, time in PACU, second-stage recovery and time to discharge. Preoperative gabapentin or intraoperative ketorolac did not decrease postoperative pain, while females had higher first PACU VAS pain scores than males (6.05 vs 5.15, P=0.0026).
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