Perioperative use of gabapentinoids for the management of postoperative acute pain: protocol of a systematic review and meta-analysis.
Acute Pain
/ prevention & control
Analgesics
/ therapeutic use
Gabapentin
/ therapeutic use
Humans
Meta-Analysis as Topic
Pain, Postoperative
/ prevention & control
Perioperative Care
/ methods
Pregabalin
/ therapeutic use
Randomized Controlled Trials as Topic
Research Design
Risk Assessment
Systematic Reviews as Topic
Acute pain
Analgesia
Anesthesiology
Gabapentinoids
Postoperative
Surgery
Journal
Systematic reviews
ISSN: 2046-4053
Titre abrégé: Syst Rev
Pays: England
ID NLM: 101580575
Informations de publication
Date de publication:
16 01 2019
16 01 2019
Historique:
received:
05
01
2018
accepted:
06
12
2018
entrez:
18
1
2019
pubmed:
18
1
2019
medline:
24
3
2020
Statut:
epublish
Résumé
Opioids are commonly used for the management of postoperative pain, but their use is limited by important adverse events, such as respiratory depression and the potential for addiction. Multimodal opioid-sparing analgesia regimens can be effectively employed to manage postoperative pain and reduce exposure to opioids. Gabapentinoids (pregabalin and gabapentin) represent an attractive class of drugs for use in multimodal regimens. The American Pain Society recommends the use of gabapentinoids during the perioperative period; however, evidence to inform such a recommendation is unclear. We will conduct a systematic review and meta-analysis of randomized clinical trials evaluating the use of systemic gabapentinoids, in comparison to other analgesic regimens or placebo in adult patients undergoing surgery. We will search MEDLINE, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), the Web of Science, and ClinicalTrials.gov databases for relevant citations. Our primary outcome will be intensity of postoperative acute pain (12 h). Our secondary outcomes will be postoperative pain intensity at 6, 24, 48 h, and 72 h, cumulative dose of opioids administered within 24, 48, and 72 h following surgery, the length of stay, chronic pain, and adverse events. Two investigators will independently select trials and extract data. We will evaluate the risk of bias of included trials using the Cochrane risk of bias tools. We will represent pooled continuous data as weighted mean differences and pooled dichotomous data as risk ratios with a 95% confidence interval. We will use random effect models and assess statistical heterogeneity with the I Our study will provide the best level of evidence to inform the effect of gabapentinoids in the management of postoperative acute pain. PROSPERO CRD42017067029.
Sections du résumé
BACKGROUND
Opioids are commonly used for the management of postoperative pain, but their use is limited by important adverse events, such as respiratory depression and the potential for addiction. Multimodal opioid-sparing analgesia regimens can be effectively employed to manage postoperative pain and reduce exposure to opioids. Gabapentinoids (pregabalin and gabapentin) represent an attractive class of drugs for use in multimodal regimens. The American Pain Society recommends the use of gabapentinoids during the perioperative period; however, evidence to inform such a recommendation is unclear.
METHODS
We will conduct a systematic review and meta-analysis of randomized clinical trials evaluating the use of systemic gabapentinoids, in comparison to other analgesic regimens or placebo in adult patients undergoing surgery. We will search MEDLINE, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), the Web of Science, and ClinicalTrials.gov databases for relevant citations. Our primary outcome will be intensity of postoperative acute pain (12 h). Our secondary outcomes will be postoperative pain intensity at 6, 24, 48 h, and 72 h, cumulative dose of opioids administered within 24, 48, and 72 h following surgery, the length of stay, chronic pain, and adverse events. Two investigators will independently select trials and extract data. We will evaluate the risk of bias of included trials using the Cochrane risk of bias tools. We will represent pooled continuous data as weighted mean differences and pooled dichotomous data as risk ratios with a 95% confidence interval. We will use random effect models and assess statistical heterogeneity with the I
DISCUSSION
Our study will provide the best level of evidence to inform the effect of gabapentinoids in the management of postoperative acute pain.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO CRD42017067029.
Identifiants
pubmed: 30651123
doi: 10.1186/s13643-018-0906-3
pii: 10.1186/s13643-018-0906-3
pmc: PMC6334388
doi:
Substances chimiques
Analgesics
0
Pregabalin
55JG375S6M
Gabapentin
6CW7F3G59X
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
24Subventions
Organisme : CIHR
Pays : Canada
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