Perioperative Use of Gabapentinoids: Comment

It was a pleasure to read the article from Verret et al. in a recent issue of Anesthesiology.¹  The main prerequisites of a high-quality systematic review were met; however, some considerations about the patient, intervention, comparison, and study design approach applied and the conclusion of the review must be addressed. The main outcomes of the meta-analysis pooled results of highly divergent procedures, from endoscopic procedures to major surgeries. A relevant issue in both the Enhanced Recovery after Surgery and the Perioperative Surgical Home doctrines is the specificity of surgical route standardization.^2,3  The possibility of another analgesic regiment being used in the comparator group is another concern. The use of gabapentin was compared with antidepressants, opioids, ketamine, nonsteroidal anti-inflammatory drugs, corticosteroids, benzodiazepines, neuroleptics, anticonvulsant, α₂-adrenergic receptor agonists, paracetamol, melatonin, and placebo....