Designed and created by Guideline Central in participation with the American Association of Hip and Knee Surgeons
Gabapentinoids in Total Joint Arthroplasty
Patient Guideline Summary
Publication Date: March 1, 2020
Last Updated: March 3, 2023
This patient summary means to discuss key recommendations from the American Association of Hip and Knee Surgeons, American Society of Regional Anesthesia and Pain Medicine, American Academy of Orthopaedic Surgeons, Hip Society, and Knee Society for gabapentinoids in total joint arthroplasty. It is limited to adults 18 years of age and older and should not be used as a reference for children.
- Two drugs used for several neurological conditions – pregabalin and gabapentin – were evaluated for their effect on pain associated with hip and knee surgery.
- The drugs were compared to placebo (“sugar pills”).
- This patient summary focuses on pain relief, opioid use and side effects from these two drugs used to treat pain from hip and knee surgery.
- Had no effect on post-operative pain.
- Only one study found a reduction in opioid use.
- There was no difference in side effects – nausea, vomiting, pruritus, dizziness and sedation.
- Several studies found a reduction in pain.
- Several studies found a reduction in opioid use.
- There was no difference in three side effects – vomiting, itching and dizziness – but risk of sedation was increased, and nausea was decreased.
- There was no difference in postoperative pain, opioid consumption, or complications between low-dose and high-dose or either drug.
- Both drugs increased the risk of confusion among elderly patients and respiratory depression when used with opioids.
Hannon CP, Fillingham YA, Browne JA, Schemitsch EH; AAHKS Anesthesia & Analgesia Clinical Practice Guideline Workgroup, Buvanendran A, Hamilton WG, Della Valle CJ. Gabapentinoids in Total Joint Arthroplasty: The Clinical Practice Guidelines of the American Association of Hip and Knee Surgeons, American Society of Regional Anesthesia and Pain Medicine, American Academy of Orthopaedic Surgeons, Hip Society, and Knee Society. J Arthroplasty. 2020 Oct;35(10):2700-2703. doi: 10.1016/j.arth.2020.05.031. Epub 2020 May 26. PMID: 32616442.
The information in this patient summary should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.