Where Will Gabapentin’s Bumpy Road Lead us? A Narrative Review of Pediatric Perioperative Gabapentinoids

IF 1.6 Q2 ANESTHESIOLOGY Current Anesthesiology Reports Pub Date : 2023-11-07 DOI:10.1007/s40140-023-00579-9
Galaxy Li, Pulsar Li
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Abstract

Abstract Purpose of Review Gabapentinoids, including gabapentin and pregabalin, have been commonly administered in the perioperative period since opioid-sparing effects were found in adults in the early 2000s. This review examines the current evidence for and against the perioperative use of gabapentinoids in children and identifies potential future directions for research. Recent Findings Many factors led to increasing use of gabapentinoids for surgical patients. The national opioid epidemic hastened the move toward the use of multimodal analgesia and early recovery after surgery protocols for both adults and children. However, subsequent adult studies have found less benefit in postoperative pain reduction than once thought, while others have investigated substantial adverse side effects. The most convincing data supporting the use of pediatric perioperative gabapentinoids show reductions in emergence agitation, postoperative nausea and vomiting (PONV), and chronic persistent surgical pain. Summary As adult trials of perioperative gabapentinoids show decreasing benefits in postoperative pain, opioid consumption, and postoperative nausea and vomiting (PONV) amidst increasing concerns of adverse side effects, benefits for children focus more on reduction in emergence agitation, PONV, and chronic postsurgical pain with more research needed to explore optimal dosing regimens and potential adverse side effects.
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加巴喷丁的坎坷之路将把我们引向何方?儿童围手术期加巴喷丁类药物的叙述性回顾
自21世纪初在成人中发现阿片类药物节约效应以来,加巴喷丁类药物(包括加巴喷丁和普瑞巴林)已被普遍用于围手术期。本文综述了目前支持和反对加巴喷丁类药物在儿童围手术期使用的证据,并确定了潜在的未来研究方向。许多因素导致加巴喷丁类药物在外科患者中的使用增加。全国性的阿片类药物流行加速了对成人和儿童使用多模式镇痛和手术后早期恢复方案的趋势。然而,随后的成人研究发现,术后疼痛减轻的好处比以前想象的要少,而其他研究则发现了大量的不良副作用。支持儿童围手术期使用加巴喷丁类药物的最具说服力的数据显示,出现时躁动、术后恶心和呕吐(PONV)以及慢性持续性手术疼痛的减少。成人围手术期试验显示,加巴喷丁类药物在术后疼痛、阿片类药物消耗和术后恶心呕吐(PONV)方面的益处不断下降,同时对不良副作用的担忧日益增加,对儿童的益处更多地集中在减少出现时躁动、PONV和慢性术后疼痛上,需要更多的研究来探索最佳给药方案和潜在的不良副作用。
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来源期刊
Current Anesthesiology Reports
Current Anesthesiology Reports Medicine-Anesthesiology and Pain Medicine
CiteScore
2.80
自引率
0.00%
发文量
47
期刊介绍: This journal aims to offer expert review articles on the most significant recent developments in the field of anesthesiology. By providing clear, insightful, balanced contributions, the journal intends to serve those involved in the delivery of anesthesia for surgical and medical procedures, treatment of acute and chronic pain conditions, perioperative management for operative and intensive care unit patients, and associated basic science and clinical research efforts in their areas. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas across the field. Section Editors select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An Editorial Board of more than 20 internationally diverse members reviews the annual table of contents, ensures that topics include emerging research, and suggests topics of special importance to their country/region. Topics covered may include ambulatory anesthesia; anesthesia and inflammation; anesthetic mechanisms; anesthetic pharmacology; cardiovascular anesthesia; critical care anesthesia; local anesthetic pharmacology; monitoring technology; neuroanesthesia; neuromuscular blockade; obstetrical anesthesia; pain mechanisms; pain therapy; patient safety; pediatric anesthesia; quality assessment; regional anesthesia; and transplantation anesthesia.
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