A large randomized clinical trial found that gabapentin, when added to multimodal analgesia after major cardiac, thoracic, or abdominal surgery, did not reduce hospital stay, opioid use, or improve long-term pain or quality of life. Early postoperative opioid reductions were brief and not sustained. Adverse events were similar between groups. Researchers concluded that gabapentin offers no meaningful recovery advantage and should not be routinely used in major surgical pain management.