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ANALGESIA

The Median Effective Dose of Preemptive Gabapentin on Postoperative Morphine Consumption After Posterior Lumbar Spinal Fusion

Alain C. Van Elstraete, MD^*, Myriam Tirault, MD^*, Thierry Lebrun, MD^*, Ignace Sandefo, MD^*, Jean-Christophe Bernard, MD^*, Bruno Polin, MD^*, Patrick Vally, MD, and Jean-Xavier Mazoit, MD, PhD

From the Departments of *Anesthesiology, Neurosurgery, Centre Médico-Chirurgical Saint Paul, Fort-de-France, Martinique, France; Univ Paris-Sud, Laboratoire d’Anesthésie, Faculté de Médecine, F-94276 Le Kremlin-Bicêtre, France; and AP-HP, Departement d’Anesthesie-Réanimation, Hôpital de Bicêtre, F-94275 Le Kremlin-Bicêtre, France.

Address correspondence to Dr. Van Elstraete, Department of Anesthesiology, Centre Médico-Chirurgical Saint Paul, Clairières, 97200 Fort-de-France, Martinique, France. Address e-mail to alainvanel{at}hotmail.com.

Abstract

BACKGROUND: A single dose of preemptive gabapentin reduces postoperative pain and postoperative analgesic consumption. However, the optimal dose of preemptive gabapentin remains to be evaluated.

METHODS: In this prospective study, we defined the median effective analgesic dose using an up-and-down sequential allocation technique of preemptive gabapentin in 67 patients undergoing elective posterior lumbar spinal fusion. The efficacy of the study drug was assessed by morphine consumption during the first 24 h postoperatively.

RESULTS: The median effective analgesic dose (median value and 95% confidence interval) of gabapentin was 21.7 mg/kg (19.9–23.5 mg/kg).

CONCLUSION: Given the large dose of gabapentin needed, further powered studies are warranted to assess side effects.

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