Gabapentin and intraoperative hypotension

Gabapentin is commonly used perioperatively as an adjunct to decrease opioid requirements and hence opioid-related adverse effects. Despite its widespread use, recent information has provided concern regarding its adverse effect profile. Perioperative gabapentin administration has been associated with greater incidence of dizziness, visual disturbances, and increased risk for postoperative pulmonary complications. We present a 13-year-old female who experienced intraoperative hypotension which was eventually attributed to the preoperative administration of gabapentin. The perioperative use of gabapentin is discussed, its adverse effect profile reviewed, and its potential role in perioperative blood pressure changes presented.