Conference Coverage

Is Gabapentin an Effective Opioid-Sparing Strategy in Orthognathic Surgery?

Anthony Calabro, MA

Key Highlights

  • Gabapentin did not significantly reduce postoperative pain scores after orthognathic surgery.
  • Patients receiving gabapentin reported higher use of opioids, ibuprofen, and acetaminophen than controls.
  • Nausea decreased in the gabapentin group by postoperative day 3.
  • Increased swelling and numbness were observed in patients treated with gabapentin.

In this prospective study, presented at the 107th American Association of Oral and Maxillofacial Surgeons Annual Meeting, Scientific Sessions and Exhibition in Washington, DC, researchers evaluated whether gabapentin could reduce postoperative opioid use and pain in patients undergoing orthognathic surgery. Contrary to expectations, gabapentin did not improve pain outcomes and was associated with higher analgesic consumption, although it did reduce postoperative nausea.

Oral and maxillofacial surgery often included postoperative exposure to opioid medications. Gabapentin, with its role in neuropathic pain control, has been explored as a potential adjunct to reduce opioid use after surgery.

A total of 43 patients treated by two senior surgeons were prospectively enrolled. The treatment group (n = 22) received gabapentin beginning with 300 mg on the night of surgery, followed by 600 mg daily for postoperative days (POD) 2 through 5. The control group (n = 21) did not receive gabapentin. Patients self-reported symptoms using daily diaries for POD 1 through 3, rating pain on a 7-point Likert scale and other symptoms (eg, swelling, numbness, nausea) on a 5-point scale. Outcomes were analyzed with exact chi-square and Mantel-Haenszel tests, with significance set at P < .05.

Attrition was notable, with only 27 of 43 patients (63%) completing diaries. Still, the results showed that gabapentin use did not lead to reduced pain scores compared with controls. On the contrary, patients in the treatment group reported significantly higher consumption of hydrocodone/acetaminophen (P = .004), ibuprofen (P = .001), and acetaminophen (P = .015) on POD 1, with trends persisting through POD 3 for hydrocodone/acetaminophen and ibuprofen. By contrast, nausea scores were significantly lower in the gabapentin group by POD 3, while swelling and numbness were reported at higher levels compared with controls.

“Based on the study results, we do not find gabapentin effective in reducing post-operative opioid consumption following orthognathic surgery,” the authors concluded.

Reference
Leininger B, Nelson DC, Blakey GH, et al. The effect of gabapentin on the reduction of postoperative pain and opioid use after orthognathic surgery. Abstract presented at: 107th American Association of Oral and Maxillofacial Surgeons Annual Meeting, Scientific Sessions and Exhibition; 2025; Washington, DC. https://aaoms-annual-meeting-2025.eventscribe.net/