EFFICACY OF GABAPENTIN IN POSTOPERATIVE PAIN MANAGEMENT FOLLOWING TOTAL HIP ARTHROPLASTY: A PROSPECTIVE RANDOMIZED STUDY.
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Keywords
Total hip arthroplasty, Gabapentin, Postoperative pain, Multimodal analgesia, Opioid consumption, Enhanced recovery after surgery
Abstract
Background: Postoperative pain following total hip arthroplasty (THA) influences early mobilization, opioid consumption, and length of hospital stay. Gabapentin has been proposed as an adjunct to multimodal analgesia due to its central sensitization–modulating properties; however, its efficacy in THA remains controversial.
Methods: This prospective randomized controlled study included 80 patients undergoing primary unilateral total hip arthroplasty at BIRRD HOSPITAL TIRUPATI a tertiary orthopaedic center between January 2023 and June 2024. Patients were allocated to receive either perioperative gabapentin (600 mg preoperatively followed by 300 mg twice daily for 48 hours) or standard multimodal analgesia without gabapentin. Postoperative pain was assessed using the Visual Analog Scale (VAS) at 6, 12, 24, and 48 hours. Total opioid consumption (morphine equivalents), time to ambulation, length of hospital stay, and adverse effects were recorded.
Results: Baseline demographic and clinical characteristics were comparable between groups. Postoperative VAS pain scores were numerically lower in the gabapentin group at all time points but did not reach statistical significance. Cumulative opioid consumption during the first 48 hours was significantly lower in the gabapentin group (18.6 ± 6.4 mg vs. 22.9 ± 7.1 mg; p = 0.01). There were no significant differences in time to first ambulation or length of hospital stay. Dizziness and somnolence occurred more frequently in patients receiving gabapentin (p < 0.05).
Conclusions: Perioperative gabapentin use following total hip arthroplasty results in a modest opioid-sparing effect without significant improvement in postoperative pain scores or functional recovery and is associated with increased sedation-related adverse effects. Routine use of gabapentin in THA cannot be recommended, and its administration should be individualized.
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Dr.Avinash Bajjuri
Assistant professor, BIRRD (T) Hospital
Dr Muni Sankar Reddy .M
Assistant professor, BIRRD (T) Hospital
Dr Jishnu J
Associate professor BIRRD (T) Hospital
