There have been 8 studies looking at the administration of Gabapentin in the postoperative period (4,6-8,11,20,22,23). Fassoulaki and colleagues (6) examined pain scores and opioid consumption in postoperative breast cancer patients. Seventy-five patients undergoing surgery for breast cancer were randomized to receive Mexiletine 600 mg/day, Gabapentin 1200 mg/day or placebo for 10 days. Opioid consumption was reduced by 50% in the Gabapentin and Mexiletine groups vs. the placebo group on days 2-10. Only the Gabapentin group had decreased pain after movement from the 2nd to the 5th postoperative day. There were no adverse effects reported in the Gabapentin group. Dierking and his colleagues randomized 80 patients to receive either 1200 mg of Gabapentin or placebo 1 hr preoperatively, then either Gabapentin 600 mg or placebo at hours 8, 16, and 24 postoperatively following abdominal hysterectomies(4). Opioid consumption was reduced by 32% in this study and there was no significant difference between side effects in either group. Another study looking at postoperative outcomes and Gabapentin was published by Gilron and his colleagues who randomized 110 patients to 4 study groups: (A) placebo (B) Gabapentin 600 mg TID (C) Rofecoxib 50 mg/day (D) Gabapentin 600 mg TID & Rofecoxib 50 mg/day starting 1hr preoperatively and continuing for 72 hours postoperatively (9). This study was unique because it went further than simply looking at pain scores and morphine consumption data. Gilron and his colleagues demonstrated that the Gabapentin and the Gabapentin and Rofecoxib groups also significantly decreased movement associated pain evoked by sitting and coughing post abdominal hysterectomy. Adverse events were similar in all groups except sedation, which was more frequent with Gabapentin. Consistent with previous literature, the multimodal Gabapentin/Rofecoxib combination demonstrated opioid sparing, lower pain scores, but most importantly, decreased movement associated pain, which may be a significant factor in faster rehabilitation. In our study we have chosen to use Gabapentin 200 mg TID (bioequivalence of 600 mg/day) based on our extensive clinical experience with our patient population. This appears to be the dose at which most patients do not exhibit the Gabapentin related side effects described earlier. Only four studies have prescribed Gabapentin beyond 72 hours postoperatively (6-8,11). This is an area in which further research is needed to determine whether prolonged postoperative administration and its benefits translate into earlier hospital discharge, decreased chronic pain rates and increased functional recovery even beyond the acute post surgical time period. By following patients to 4 weeks post surgery, this study will aim to answer some of the questions regarding the perioperative use of gabapentin and its possible role ameliorating functional recovery beyond the acute hospitalization period.