Trial Information

Stanford Accelerated Recovery Trial (START)

Gabapentin was originally developed as an anti-convulsant, but was quickly recognized as a
medication with significant analgesic activity in patients with neuropathic pain. More
recently it has begun to be appreciated that it may have some benefits in the peri-operative
period. Pre-operative Gabapentin reduces preoperative anxiety, early post-operative pain
severity, post-operative opioid use and post-operative delirium (presumably through reduced
opioid consumption). These same attributes are shared by medications such as NSAIDS and
tylenol and the use of peri-operative gabapentin has not permeated the standard of care.
Early post-operative pain severity and preoperative anxiety have been implicated in our own
research as risk factors for prolonged time to pain resolution and prolonged time to opioid
cessation. Since these endpoints are generally synonymous with time to recovery,
interventions reducing these times would be seen not just to increase comfort but to
actually speed recovery.