Key result
Preoperative gabapentin dosage per kg was not significantly correlated with post-anesthesia care unit length of stay after adjusting for confounders (+1.71 minutes per 1 mg/kg, p=0.54).
Why the study?
Gabapentin is routinely prescribed preoperatively to reduce postoperative pain, but its correlation with post-anesthesia care unit length of stay and hospital cost required analysis.
Does higher preoperative gabapentin dosage increase PACU length of stay in patients undergoing pelvic and breast surgery?
Observational (n=636)
No
Does higher preoperative gabapentin dosage increase PACU length of stay in patients undergoing pelvic and breast surgery?
Higher doses of preoperative gabapentin (300 mg vs 100 mg) did not significantly increase PACU length of stay when adjusted for confounders, though unadjusted data showed a longer stay and increased costs.
This is the authors' abstract. We don't add key points for this paper.
Background: Gabapentin is routinely prescribed preoperatively to decrease postoperative pain intensity. It is included in the enhanced recovery after surgery (ERAS) recommendations. Objective: To analyze correlation of gabapentin dosage and post anesthesia care unit (PACU) length of stay (LOS) and cost. Study Design: A retrospective chart review of patients who underwent general anesthesia and received preoperative oral gabapentin from June 2017 to August 2017 for pelvic and breast procedures. The main outcome was correlation between PACU LOS and gabapentin dosage in the outpatients. Financial analysis was performed to assess the cost to the hospital associated with increased LOS. Results: Of the 636 patients, 405 patients received 300 mg and 231 patients received 100 mg gabapentin. Mean dosage per kg (mg/kg ± SD) was 3.12 ± 1.51 (range: 0.86 to 6.12). PACU LOS was 96 ± 77 (minutes ± SD) in patients receiving 100 mg and 120 ± 96 in patients receiving 300 mg capsule (p = 0.001). Linear regression analysis, failed to show a statistically significant correlation between per kg dosage and PACU LOS (p = 0.13). Using multiple regression analysis, we calculated the correlation coefficient to be +1.71 minutes per 1mg/kg gabapentin (95% CI: -3.75 to +7.10, p = 0.54) after adjusting for confounders. Adding 3 mg/kg to pre-op gabapentin dosage of all outpatients cost on average, an extra $9794 per month in this cohort. Conclusion: Every 1mg/kg increase in gabapentin dosage adds an estimated 7.1 minutes to PACU LOS. A 3 mg/kg increase in gabapentin adds estimated 22 additional minutes in PACU LOS. Unfortunately, increase LOS is associated with increased hospital costs.
Adjusted analysis showed no gabapentin dose effect on PACU stay; leaves open optimal preoperative dosing in pelvic and breast surgery.
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Alshiek et al. (2021) conducted an observational in Pelvic and breast surgery (n=636). Preoperative gabapentin dosage vs. Lower gabapentin dosage was evaluated on Correlation between PACU length of stay and gabapentin dosage per kg (+1.71 minutes per 1mg/kg, 95% CI -3.75 to +7.10, p=0.54). Preoperative gabapentin dosage per kg was not significantly correlated with post-anesthesia care unit length of stay after adjusting for confounders (+1.71 minutes per 1 mg/kg, p=0.54).
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