Pattern of perioperative gabapentinoid use and risk for postoperative naloxone administration.

Preoperative gabapentinoid (gabapentin and pregabalin) administration has been associated with respiratory depression during anaesthesia recovery. This study assessed associations between chronic (home) use and perioperative (preoperative and postoperative) use of gabapentinoids, and risk for severe over-sedation or respiratory depression as inferred from the use of naloxone. Single center retrospective analysis of 128 patients who received general anaesthesia  and required naloxone administration within 48 h postoperatively. Patients were 2:1 matched on age, sex, and type of procedure. Multivariable analysis detected significant interactions between chronic and postoperative use of gabapentinoids, where continuation of chronic gabapentinoid medications into the postoperative period was associated with an increased rate of naloxone administration. Obstructive sleep apnoea and preoperative disability were also associated with an increased risk for postoperative naloxone administration. Continuation of chronic gabapentinoid medications into the postoperative period as well as OSA are associated with the increased use of naloxone to reverse over-sedation or respiratory depression.

https://www.ncbi.nlm.nih.gov/pubmed/29576120