TITLE:
Preoperative Gabapentin Dosage Relationship to Length of Stay in Post-Anesthesia Care Unit in Patients Undergoing Pelvic and Breast Surgery
AUTHORS:
Jonia Alshiek, Sara Hamade, Jennifer A. R. Vaz, S. Abbas Shobeiri
KEYWORDS:
Gabapentin, Enhanced Recovery after Surgery, Post Anesthesia Care Unit, Length of Stay
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.11 No.12,
December
30,
2021
ABSTRACT: Background: Gabapentin is routinely
prescribed preoperatively to decrease postoperative pain intensity. It is
included in the enhanced recovery after surgery (ERAS) recommendations. Objective: To analyze correlation of
gabapentin dosage and post anesthesia care unit (PACU) length of stay (LOS) and
cost. Study Design: A retrospective
chart review of patients who underwent general anesthesia and received
preoperative oral gabapentin from June 2017 to August 2017 for pelvic
and breast procedures. The main outcome was correlation between PACU LOS and
gabapentin dosage in the outpatients. Financial analysis was performed to
assess the cost to the hospital associated with increased LOS. Results: Of the 636 patients, 405
patients received 300 mg and 231 patients
received 100 mg gabapentin. Mean dosage per kg (mg/kg ± SD)
was 3.12 ± 1.51
(range: 0.86
to 6.12). PACU LOS was 96 ± 77
(minutes ± SD)
in patients receiving 100 mg and 120 ± 96 in patients receiving
300 mg capsule (p = 0.001).
Linear regression analysis, failed to show a statistically
significant correlation between per kg dosage and PACU LOS (p = 0.13).
Using multiple regression analysis, we calculated the correlation coefficient
to be +1.71 minutes per 1mg/kg gabapentin (95% CI: -3.75 to +7.10, p = 0.54)
after adjusting for confounders. Adding 3 mg/kg to pre-op gabapentin dosage of all outpatients cost on
average, an extra $9794
per month
in this cohort. Conclusion: Every
1mg/kg increase in gabapentin dosage adds an estimated 7.1 minutes to PACU LOS.
A 3 mg/kg
increase in gabapentin adds estimated 22 additional minutes in PACU LOS.
Unfortunately, increase LOS is associated with increased hospital costs.