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Meta-Analysis
. 2017 Sep;96(37):e8007.
doi: 10.1097/MD.0000000000008007.

The efficacy of gabapentin in reducing pain intensity and postoperative nausea and vomiting following laparoscopic cholecystectomy: A meta-analysis

Lifeng Wang  1 , Yucai Dong, Jiling Zhang, Hongwu Tan
Affiliations
Meta-Analysis

The efficacy of gabapentin in reducing pain intensity and postoperative nausea and vomiting following laparoscopic cholecystectomy: A meta-analysis

Lifeng Wang et al. Medicine (Baltimore). 2017 Sep.

Abstract

Background: It is unknown whether gabapentin is effective in reducing acute pain following laparoscopic cholecystectomy. The purpose of the current meta-analysis was to evaluate the efficacy of gabapentin in reducing pain intensity and postoperative nausea and vomiting (PONV) after laparoscopic cholecystectomy.

Methods: All randomized controlled trials (RCTs) evaluating the efficacy of gabapentin in reducing pain intensity and PONV after laparoscopic cholecystectomy were searched on the following databases: PubMed, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), the Google database, the Chinese Wanfang database, and the China National Knowledge Infrastructure (CNKI). The most recent literature search was conducted on March 21, 2017. Outcomes including visual analog scale (VAS) at 12 and 24 hours, total morphine consumption, and the occurrence of PONV. Continuous outcomes were expressed as the weighted mean difference (WMD) and 95% confidence interval (CI), and the one discontinuous outcome was expressed as risk ratio (RR) and 95% CI. Stata 12.0 software was used for meta-analysis.

Results: A total of 9 studies involving 966 patients were identified. In total, there were 484 gabapentin subjects and 482 controls. Compared with the control group, gabapentin was associated with lower VAS at 12 hours (WMD = -10.18, 95% CI: -17.36 to -2.80, P = .007) and 24 hours (WMD = -6.33, 95% CI: -8.41 to -4.25, P = .000), which was equivalent on a 110-point VAS scale to 10.18 points at 12 hours and 6.33 points at 24 hours. Compared with the control group, gabapentin was associated with less total morphine consumption by approximately 110.83 mg (WMD = -110.83, 95% CI: -183.25 to -38.42, P = .003). In addition, the occurrence of nausea and vomiting in gabapentin was decreased (25.2% vs 47.6, RR = 0.53, 95% CI: 0.44-0.63, P = .000).

Conclusion: Gabapentin was efficacious in reducing postoperative pain, total morphine consumption, and morphine-related complications following laparoscopic cholecystectomy. In addition, there was a negative correlation between the gabapentin dosage and the occurrence of nausea and vomiting. The number of included studies is limited, and more studies are needed to verify the effects of gabapentin in laparoscopic cholecystectomy patients.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Flowchart of study search and inclusion criteria.
Figure 2
Figure 2
Risk of bias of included randomized controlled trials. +, No bias; −, bias; ?, bias unknown.
Figure 3
Figure 3
Risk of bias graph.
Figure 4
Figure 4
Forest plots of the included studies comparing the VAS at 12 hours.
Figure 5
Figure 5
Funnel plot of VAS at 12 hours.
Figure 6
Figure 6
Begg test of VAS at 12 hours.
Figure 7
Figure 7
Forest plots of the included studies comparing the VAS at 24 hours.
Figure 8
Figure 8
Forest plots of the included studies comparing the total morphine consumption.
Figure 9
Figure 9
Forest plots of the included studies comparing the occurrence of nausea and vomiting.
Figure 10
Figure 10
Scatter plot showing the relationship between the dosage of gabapentin and the occurrence of nausea and vomiting.
Figure 11
Figure 11
(A) TSA results for VAS at 12 hours, (B) TSA results for VAS at 24 hours, (C) TSA results for total morphine consumption, (D) TSA results for the occurrence of nausea and vomiting.
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