One Stone, Two Birds: Response to Letter to the Editor by Gurunthalingam et al.

Including studies that used gabapentinoids for perioperative pain management and observed pruritus as an adverse reaction to opioids meets the inclusion criteria. We argue that integrating these studies provides insight into the dual role of gabapentinoids in managing opioid-induced pruritus, effectively achieving multiple benefits from a single intervention. Although the primary focus of the original studies was on the analgesic effects of gabapentinoids during the perioperative period, they also recorded the incidence of opioid-induced pruritus, serving as key outcome measures for our review. Unexpectedly, our pooled analysis found a statistically significant reduction in the incidence of opioid-induced pruritus following the use of gabapentinoids. Regarding the issue that inconsistent timing of gabapentinoids administration may affect the evaluation of their efficacy on opioid-induced pruritus, we believe that all these cases, whether involving preoperative, postoperative, or both administrations, fall under the perioperative use of gabapentinoids. Therefore, the timing of drug administration is not a variable; rather, whether gabapentinoids are used perioperatively is the variable influencing the outcome measure of pruritus incidence. For sections where discrepancies were noted between the data we extracted and the original studies, such as medication timing and reported outcomes, we have also provided explanations.