Gabapentin Premedication for Pediatric Anterior Cruciate Ligament Reconstruction: A Feasibility Study
Margaret Gettis, David Nusz, Jodi Roberts, Jane Chen, Allison Musick, Martha Wetzel, and Courtney McCracken
Purpose: Anterior cruciate ligament (ACL) reconstruction surgery is common, with significant postoperative pain. Few studies have assessed gabapentin for pain in adolescent ACL populations.
Design: A feasibility study measured efficacy of single preoperative gabapentin doses to reduce postoperative pain in adolescents aged 12 to 18 years undergoing ACL reconstruction versus placebo.
Methods: Primary efficacy outcome was postoperative opioid use, with pain, safety, and pain management satisfaction secondary.
Findings: Fifty-five patients enrolled. Gabapentin had an early effect in reducing mean narcotic use 24 hours postoperatively. No significant difference was demonstrated overall in the two groups. Over half of patients were still taking opioids at day 4/5; current guidelines recommend 3 days or less. Median satisfaction score, one point higher for gabapentin group versus placebo group, was not statistically significant.
Conclusion: Results demonstrate gabapentin may be an effective medication to reduce acute postoperative pain. However, robust methodology is needed to more accurately assess and treat pain.