Accessible Unlicensed Requires Authentication Published by De Gruyter March 6, 2018

The influence of pre- and perioperative administration of gabapentin on pain 3–4 years after total knee arthroplasty

Kristian Kjær Petersen, Troels Haxholdt Lunn, Henrik Husted, Lars Tambour Hansen, Ole Simonsen, Mogens Berg Laursen, Henrik Kehlet and Lars Arendt-Nielsen

Abstract

Background and aims:

Approximately 20% of patients having total knee arthroplasty (TKA) will experience chronic postoperative pain. Recently, preoperative pain facilitation has been associated with chronic pain after TKA, and gabapentin has been shown to decrease pain facilitation. The current study is a secondary follow-up of a primary RCT investigating the effect of gabapentin on acute postoperative pain after TKA and exploring the effect of pre- and perioperative administration of gabapentin on chronic postoperative pain and psychological state 3–4 years after TKA.

Methods:

Patients scheduled for TKA were randomized to either gabapentin 1,300 mg/day, gabapentin 900 mg/day, or placebo daily from 2-h before and 6 days after operation. Pre- and 3–4 years postoperatively pain scores related to pain while walking, at rest, when flexing the hip or the knee were collected. At the same time, the pain catastrophizing scale (PCS) and hospital anxiety and depression scale subscales for anxiety (HADS-A) and depression (HADS-D) were collected.

Results:

Lower postoperative pain while walking, flexing the hip, and at rest were found compared with preoperative scores (p<0.03), but these were not associated with gabapentin treatment (p>0.19). Significantly lower postoperative PCS and HADS-A scores were seen compared with preoperative scores (p<0.001), but these were not associated with gabapentin treatment (p>0.55).

Conclusions:

The current study found that pre- and perioperative administrations of gabapentin do not influence the pain or psychological state 3–4 years after TKA.

Implications:

The current study does not support that short-term pre- and perioperative use of gabapentin can reduce the development of chronic postoperative pain after TKA.

  1. Authors’ statements

  2. Research funding: The study was supported with a research grant from The Lundbeck Foundation, Hellerup, Denmark, which is independent of the pharmaceutical company, Lundbeck Pharma, Denmark.

  3. Conflict of interest: None declared.

  4. Informed Consent: Oral and written informed consents were obtained from all patients.

  5. Ethical Approval: The primary study was approved by the Danish Medicines Agency, the regional ethics committee, and the Danish Data Protection Agency and was registered at EudraCT (2011-003105-22) and www.clinicaltrials.gov (NCT01507363, January 6, 2012).

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Received: 2018-01-24
Revised: 2018-02-08
Accepted: 2018-02-14
Published Online: 2018-03-06
Published in Print: 2018-04-25

©2018 Scandinavian Association for the Study of Pain. Published by Walter de Gruyter GmbH, Berlin/Boston. All rights reserved.