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Risk-benefit assessment needed before perioperative gabapentin use in older adults

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The use of gabapentin for perioperative pain management in older patients was associated with an increased risk of delirium, new antipsychotic use, and pneumonia, according to a study.

Gabapentin has been used more frequently in perioperative pain management to reduce opioid use.

In this retrospective cohort study, data from 237,872 patients ≥65 years who underwent major surgery and did not use gabapentin before surgery were included.

Propensity score matching identified 118,936 pairs of gabapentin users and nonusers.

Gabapentin users had an increased risk of delirium, new antipsychotic use, and pneumonia compared to nonusers but no difference in in-hospital death was noted between the groups.

Among gabapentin users, a greater risk of delirium was found in patients with high comorbidity burden compared with low comorbidity burden and chronic kidney disease.

Park CM, Inouye SK, Marcantonio ER, et al. Perioperative Gabapentin Use and In-Hospital Adverse Clinical Events Among Older Adults After Major Surgery. JAMA Intern Med. Published online September 19, 2022. doi:10.1001/jamainternmed.2022.3680