Efficacy of preemptive gabapentin for laparoscopic cholecystectomy: a meta-analysis of randomized controlled trials

Purpose: Laparoscopic cholecystectomy (LC) is one of the most popular surgical procedures, while pain after this surgery still presents a major challenge mostly involving the responsible use of opioids. This meta-analysis was conducted to evaluate the efficacy of preemptive gabapentin for LC. Methods: Two researchers independently searched the following three main databases: PubMed, Embase and Cochrane Central Register of Controlled Trials for randomized controlled trials (RCTs). The data of these trials were analyzed using Review Manager. Results: Twelve RCTs with 1192 patients were included in this meta-analysis. Preemptive gabapentin decreased consumption of analgesic agent (standard mean difference (SMD) -1.68, 95% CI -2.81 to -0.56) and Visual Analogue Scale (SMD -0.63, 95% CI -1.27 to -0.00) compared with placebo. And we found significant decrease in postoperative nausea and vomiting (Risk Ratio (RR) 0.83, 95% CI 0.48 to 0.79) with not less than 600 mg gabapentin administrated, as well as the rescue antiemetic (RR 0.58, 95% CI 0.40 to 0.84). Furthermore, significant reductions in MAP at 15th minute post pneumoperitoneum (SMD -2.00, 95% CI -3.72 to -0.29) were also elicited. Conclusions: The current meta-analysis exhibits that oral administration of preemptive gabapentin is superiority to placebo in decreasing postoperative pain scores, analgesic consumption, and postoperative nausea and vomiting and can keep hemodynamic stability for LC.