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composite outcome. The results were consistent across sensitivity analyses and subgroups identified by key clinical factors. In this real-world cohort study of patients who underwent major surgery, concomitant use of gabapentinoids with opioids was associated with increased risk of opioid overdose and other opioid-related adverse events; however, the absolute risk of adverse events was low. In this real-world cohort study of patients who underwent major surgery, concomitant use of gabapentinoids with opioids was associated with increas