Yan, P.Z., Butler, P.M., Kurowski, D., & Perloff, M.D. (2014). Beyond neuropathic pain: Gabapentin use in cancer pain and perioperative pain. The Clinical Journal of Pain, 30, 613–629.

Purpose

STUDY PURPOSE: To conduct a clinical evidence review of gabapentin's use in the management of perioperative pain and cancer-related pain
 
TYPE OF STUDY: Systematic review

Search Strategy

DATABASES USED: PUBMED and Ovid MEDLINE
 
KEYWORDS: Surgery and cancer, both cross-referenced with gabapentin and pain
 
INCLUSION CRITERIA: Clinical trial studies for the treatment of cancer-related and surgical pain with the quality of evidence at level II-2 or higher; nonhuman studies were included for cancer-related pain
 
EXCLUSION CRITERIA: Nonblinded studies, case reports that did not present a unique finding, and studies that focused on neuropathic pain only

Literature Evaluated

TOTAL REFERENCES RETRIEVED: 142
 
EVALUATION METHOD AND COMMENTS ON LITERATURE USED: Each abstract was read by two reviewers and was excluded or included based on the criteria detailed in the search strategy. The resulting references were then read, reviewed, analyzed, and discussed with special attention to clinical trials with the quality of evidence at a level II-2 or higher (as defined by Berg, A., & Allan, J. (2001). Introducing the third US Preventive Services Task Force. American Journal of Preventive Medicine, 20, 21–35.)

Sample Characteristics

  • FINAL NUMBER STUDIES INCLUDED = 48 
  • TOTAL PATIENTS INCLUDED IN REVIEW = Unknown
  • SAMPLE RANGE ACROSS STUDIES: 20–498 patients
  • KEY SAMPLE CHARACTERISTICS: Patients with cancer-related pain treated with gabapentin and postsurgical patients with related pain being treated with gabapentin

Phase of Care and Clinical Applications

APPLICATIONS: Pediatrics, elder care, and palliative care

Results

Gabapentin was found to be effective in reducing pain and the use of analgesics when used perioperatively for otolaryngology, orthopedic, abdominal, and pelvic surgeries as well as mastectomies. There was scant efficacy noted following cardiothoracic surgery. Studies of cancer-related pain management regimens that included gabapentin demonstrated a substantial outcome, which included mild to moderate pain relief with increased efficacy noted in patients with neuropathic pain as well as cancer-related pain.

Conclusions

Gabapentin was proved to be therapeutic as an adjuvant treatment for cancer-related pain. The authors found multiple studies concluding that gabapentin was effective as part of an analgesic regimen for cancer-related pain. They also effectively described the results of double-blinded, randomized, placebo-controlled research supporting the conclusion in favor of the perioperative use of gabapentin as an adjuvant analgesic.

Limitations

The articles that were reviewed incorporated disproportionately more patients with breast, lung, and colorectal cancers.

Nursing Implications

Nurses are in a position to gather additional data and contribute to research, providing more evidence to support the use of gabapentin as an adjuvant analgesic as a part of an effective procedure in the case of perioperative pain. Nurses also are in a position to provide efficient research reviews of studies that evaluate the effect of gabapentin.

Legacy ID

5204