Gabapentin for Pain Management in Total Joint Arthroplasty: An Evidence-Based Practice Project

Gabapentin is routinely used in preoperative multimodal anesthesia to reduce pain following total joint arthroplasty (TJA) surgery. Evolving evidence has shown it is ineffective in reducing postoperative pain and should be used cautiously in this patient population due to its adverse effects. The purpose of this work was to implement an evidence-based practice (EBP) change in a small preadmission testing center. Utilizing the Melnyk EBP model, implementation occurred over 30 days. Pharmacy reports were used to determine the number of doses of gabapentin 300 mg dispensed from the ASU Phase II Omnicell 30 days before implementation and 30 days following implementation. During implementation, there was 23.8% reduction in gabapentin administration preoperatively. Advanced practice registered nurses (APRNs) removed gabapentin from the preoperative order set, resulting in a decrease in gabapentin use. This work demonstrates the role APRNs have in driving EBP changes.