THE ROLE OF GABAPENTINOIDS IN ORTHOPEDIC SURGERIES - IMPACT ON PAIN CONTROL, OPIOID CONSUMPTION, AND FUNCTIONAL OUTCOMES

Background Postoperative pain after orthopedic surgery remains a major clinical problem and is commonly managed using multimodal analgesia. Gabapentinoids have been proposed as opioid sparing adjuncts, but their clinical effectiveness and impact on functional recovery remain uncertain. Aim To evaluate the effects of gabapentin and pregabalin on postoperative pain intensity, opioid consumption, and functional outcomes in patients undergoing orthopedic surgical procedures. Methods A narrative literature review was performed based on prospective clinical trials published between 2015 and 2025. The literature search was conducted using the Google Scholar database. Twenty one prospective studies evaluating postoperative pain assessed by VAS or NRS scales, opioid consumption, and functional outcomes after orthopedic surgery were included. Results The effects of gabapentinoids on postoperative pain reduction were variable across studies. Pregabalin demonstrated more consistent analgesic benefits compared with gabapentin, particularly in the early postoperative period. Several studies reported a reduction in opioid consumption associated with the use of gabapentinoids, although this effect was not observed consistently. No improvement in long term functional outcomes was demonstrated in any of the included studies. Conclusions Current evidence suggests that gabapentinoids may provide modest and inconsistent benefits in postoperative pain control and opioid sparing after orthopedic surgery, with pregabalin showing more favorable results than gabapentin. Their use does not appear to influence long term functional recovery. The lack of standardized dosing protocols and limited data in pediatric populations highlight the need for further well designed clinical studies.