Efficacy of 50 mg pregabalin for prevention of postoperative neuropathic pain after video-assisted thoracoscopic surgery and thoracotomy: a 3-month prospective randomized controlled trial

Homma, Takashi; Doki, Yoshinori; Yamamoto, Yutaka; Ojima, Toshihiro; Shimada, Yasuhiro; Kitamura, Naoya; Akemoto, Yushi; Hida, Yuki; Yoshimura, Naoki

doi:10.21037/jtd.2019.02.77

Cited by 10 publications

(15 citation statements)

References 20 publications

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“…Homma et al. [ 22 ] administered pregabalin for 3 months from the second postoperative day. All patients received NSAIDs and had thoracic epidural analgesia for 2 days after surgery.…”

Section: Resultsmentioning

confidence: 99%

PROSPECT guidelines for video‐assisted thoracoscopic surgery: a systematic review and procedure‐specific postoperative pain management recommendations

et al. 2021

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Video-assisted thoracoscopic surgery has become increasingly popular due to faster recovery times and reduced postoperative pain compared with thoracotomy. However, analgesic regimens for video-assisted thoracoscopic surgery vary significantly. The goal of this systematic review was to evaluate the available literature and develop recommendations for optimal pain management after video-assisted thoracoscopic surgery. A systematic review was undertaken using procedure-specific postoperative pain management (PROSPECT) methodology. Randomised controlled trials published in the English language, between January 2010 and January 2021 assessing the effect of analgesic, anaesthetic or surgical interventions were identified. We retrieved 1070 studies of which 69 randomised controlled trials and two reviews met inclusion criteria. We recommend the administration of basic analgesia including paracetamol and non-steroidal anti-inflammatory drugs or cyclo-oxygenase-2-specific inhibitors pre-operatively or intra-operatively and continued postoperatively. Intra-operative intravenous dexmedetomidine infusion may be used, specifically when basic analgesia and regional analgesic techniques could not be given. In addition, a paravertebral block or erector spinae plane block is recommended as a first-choice option. A serratus anterior plane block could also be administered as a secondchoice option. Opioids should be reserved as rescue analgesics in the postoperative period.

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“…Homma et al. [ 22 ] administered pregabalin for 3 months from the second postoperative day. All patients received NSAIDs and had thoracic epidural analgesia for 2 days after surgery.…”

Section: Resultsmentioning

confidence: 99%

PROSPECT guidelines for video‐assisted thoracoscopic surgery: a systematic review and procedure‐specific postoperative pain management recommendations

et al. 2021

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“…Previously, we have reported on neuropathic pain after thoracic surgery (15)(16)(17). The risk factors for neuropathic pain were preoperative use of hypnotic medication, thoracotomy, and duration of surgery ≥2.5 h, and VATS was negatively associated with postoperative neuropathic pain (15).…”

Section: The Development Of Minimally Invasive Approachesmentioning

confidence: 98%

“…The risk factors for neuropathic pain were preoperative use of hypnotic medication, thoracotomy, and duration of surgery ≥2.5 h, and VATS was negatively associated with postoperative neuropathic pain (15). Pregabalin (50 mg/day) had a significant preventive effect on postoperative neuropathic pain after thoracic surgery, and the duration of neuropathic pain was significantly shorter, without obvious side effects (16). Nevertheless, 19.6% of patients experienced postoperative neuropathic pain after lung resection.…”

Section: The Development Of Minimally Invasive Approachesmentioning

confidence: 99%

“…Ideally, patients should be asymptomatic after surgery. Our previous studies showed that multidimensional approaches are necessary to achieve symptom-free status, including less invasive surgical approaches, additional pain control methods, and the time effect (15)(16)(17).…”

Section: The Development Of Minimally Invasive Approachesmentioning

confidence: 99%

“…When a chest tube could not be removed, epidural analgesia or intravenous fentanyl infusion was stopped by postoperative day 14 according to pain. All patients received intraoperative internal intercostal nerve block (21) and loxoprofen 180 mg/day from the first postoperative day and 25 mg pregabalin twice daily from the second postoperative day through phase I-III (16). Intercostal nerve blocks were performed at port location levels using 20 mL 0.75% lopivacaine.…”

Section: Pain Managementmentioning

confidence: 99%

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Decreased postoperative complications, neuropathic pain and epidural anesthesia-free effect of uniportal video-assisted thoracoscopic anatomical lung resection: a single-center initial experience of 100 cases

Homma¹,

Shimada²,

Tanabe³

2022

J Thorac Dis

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Background: We aimed to analyze perioperative complications, postoperative neuropathic pain, and the necessity of epidural anesthesia in uniportal video-assisted thoracoscopic surgery (U-VATS) compared to conventional multiportal VATS (M-VATS) for anatomical lung resection. Methods: This retrospective study included all patients who underwent elective VATS lobectomy and segmentectomy between April 2016 and December 2019. The exclusion criteria were as follows: age ≤19 years, planned thoracotomy, re-operation in thoracic surgery, median sternotomy, robot-assisted thoracic surgery, simultaneous resection of extrathoracic organs, locally invasive lung tumor with bronchoplasty or angioplasty, past or current neuropathic pain, and a large tumor with a minimum diameter ≥5 cm. M-VATS had 4 ports approach. U-VATS port positions were placed by extending the thoracoscope port of M-VATS. Results: U-VATS patients showed significant differences compared to M-VATS patients: smaller intraoperative bleeding (1 vs. 30 mL; P=0.0010), shorter operative time (141 vs. 183 min; P<0.0001), posthospitalization (5 vs. 8 days; P=0.0002), fewer complications (23.9% vs. 40.9%; P=0.048), less acute pain, less postoperative neuropathic pain (32.4% vs. 52.1%; P=0.027) and shorter duration of neuropathic pain (30 vs. 60 days; P=0.041). For the postoperative neuropathic pain and pain score until postoperative day 5, there were no differences between the groups with and without epidural anesthesia. Conclusions: As a single-center initial experience, U-VATS lobectomy and segmentectomy seemed safe and minimally invasive based on not only postoperative neuropathic pain and complications but also time management. U-VATS would provide better pain control, without epidural anesthesia.

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Investigating the effect of pregabalin on postoperative pain in non-emergency craniotomy

Sane

Mahoori

Abdulabbas

et al. 2023

Clinical Neurology and Neurosurgery

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Efficacy of 50 mg pregabalin for prevention of postoperative neuropathic pain after video-assisted thoracoscopic surgery and thoracotomy: a 3-month prospective randomized controlled trial

Cited by 10 publications

References 20 publications

PROSPECT guidelines for video‐assisted thoracoscopic surgery: a systematic review and procedure‐specific postoperative pain management recommendations

PROSPECT guidelines for video‐assisted thoracoscopic surgery: a systematic review and procedure‐specific postoperative pain management recommendations

Decreased postoperative complications, neuropathic pain and epidural anesthesia-free effect of uniportal video-assisted thoracoscopic anatomical lung resection: a single-center initial experience of 100 cases

Investigating the effect of pregabalin on postoperative pain in non-emergency craniotomy

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