Preemptive Use of Gabapentin in' Abdominal Hysterectomy: A Systematic Review and Meta-analysis

摘要

Opioids relieve posthysterectomy pain, but their use is limited by their inherent dose-related adverse effects and other shortcomings. Therefore, an additional nonopioid agent is often required to lower the dose of the opioid. One such agent is gabapentin, a third-generation antiepileptic drug. Several randomized studies have evaluated the effectiveness of preemptive gabapentin before surgical incision for hysterectomy as well as combined use of preemptive and postoperative gabapentin. This meta-analysis and systematic review examined the evidence for preemptive use of gabapentin in abdominal hysterectomy. A search for articles published between 2004 and 2013 was conducted using the following electronic databases: PubMed, EMB ASE, Ovid MEDLINE, ClinicalTrials.gov, and Cochrane Central Register of Controlled Trials. The search was performed following the PRISM A (Preferred Reporting Items for Systematic Reviews and Meta-analyses) statement. Medical search subject heading terms, keywords, and their combinations used included "postoperative pain," "hysterectomy," "gynecologic surgical procedures," "gabapentin," "preemptive analgesia," and "preemptive anesthesia." A manual search of the reference lists in identified studies was conducted. Articles included were double-blind randomized controlled trials of women who underwent a total abdominal hysterectomy (with or without bilateral salpingo-oophorectomy), under general anesthesia using a preoperative dose of gabapentin.