Sun21November0437PM 4

True / False

Is associated with fewer neurological side effects than gabapentin, but is more sedating Incorrect answer selected

Consistently improves outcomes after day case surgery Correct

Increases the risk of postoperative nausea and vomiting Correct

Reduces opioid consumption when used perioperatively Correct

Acts as an agonist at the GABAB receptor Incorrect answer selected

Explanation

Gabapentinoids do not act at a GABA receptor, but rather on presynaptic calcium channels. They are widely used as anti-neuropathic agents in chronic pain medicine and have found use in perioperative care. However, they are associated with frequent side effects particularly visual disturbance (NNH - 6).

Gapapentin is an older agent in the same class which has a different side effect profile. It is more sedating but less commonly associated with certain neurological side effects.

The benefits of pregabalin are a consistent reduction in perioperative opioid consumption. This is more apparent after major surgery. There is a small reduction in PONV. For minor, day case or less painful surgery, the consensus suggests that the risks of harm outweigh the benefits and side effects are more commonly reported. It may be of benefit for major surgery.

Reference:

Ramaswamy S, Wilson JA, Colvin L. Non-opioid-based adjuvant analgesia in perioperative care. Contin Educ Anaesth Crit Care Pain. 2013;13:152-157.

Answer Statistics

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Average score: 68.30%

Times answered: 277