Efficacy of Pregabalin in Acute Postoperative Pain Under Different Surgical Categories

Abstract

The efficacy of pregabalin in acute postsurgical pain has been demonstrated in numerous studies; however, the analgesic efficacy and adverse effects of using pregabalin in various surgical procedures remain uncertain. We aim to assess the postsurgical analgesic efficacy and adverse events after pregabalin administration under different surgical categories using a systematic review and meta-analysis of randomized controlled trials.A search of the literature was performed between August 2014 to April 2015, using PubMed, Ovid via EMBASE, Google Scholar, and ClinicalTrials.gov with no limitation on publication year or language. Studies considered for inclusion were randomized controlled trials, reporting on relevant outcomes (2-, 24-hour pain scores, or 24 hour morphine-equivalent consumption) with treatment with perioperative pregabalin.Seventy-four studies were included. Pregabalin reduced pain scores at 2 hours in all categories: cardiothoracic (Hedge's g and 95%CI, −0.442 [−0.752 to −0.132], P = 0.005), ENT (Hedge g and 95%CI, −0.684 [−1.051 to −0.316], P < 0.0001), gynecologic (Hedge g, 95%CI, −0.792 [−1.235 to −0.350], P < 0.0001), laparoscopic cholecystectomy (Hedge g, 95%CI, –0.600 [–0.989 to –0.210], P = 0.003), orthopedic (Hedge g, 95%CI, −0.507 [−0.812 to −0.202], P = 0.001), spine (Hedge g, 95%CI, −0.972 [−1.537 to −0.407], P = 0.001), and miscellaneous procedures (Hedge g, 95%CI, −1.976 [−2.654 to −1.297], P < 0.0001). Pregabalin reduced 24-hour morphine consumption in gynecologic (Hedge g, 95%CI, −1.085 [−1.582 to −0.441], P = 0.001), laparoscopic cholecystectomy (Hedge g, 95%CI, –0.886 [–1.652 to –0.120], P = 0.023), orthopedic (Hedge g, 95%CI, −0.720 [−1.118 to −0.323], P < 0.0001), spine (Hedge g, 95%CI, −1.016 [−1.732 to −0.300], P = 0.005), and miscellaneous procedures (Hedge g, 95%CI, −1.329 [−2.286 to −0.372], P = 0.006). Pregabalin resulted in significant sedation in all surgical categories except ENT, laparoscopic cholecystectomy, and gynecologic procedures. Postoperative nausea and vomiting was only significant after pregabalin in miscellaneous procedures.Analgesic effects and incidence of adverse effects of using pregabalin are not equal in different surgical categories.

The efficacy of pregabalin for the management of postoperative pain in primary total knee and hip arthroplasty: a meta-analysis

“…This result agrees with those of other studies examining the administration of pregabalin [10, 14, 19]. Another meta-analysis showed that pregabalin can reduce 24-h morphine consumption in gynecologic, laparoscopic cholecystectomy, orthopedic, spine, and miscellaneous procedures [20]. These outcomes indicate that ideal analgesic effects can be achieved with less morphine consumption when pregabalin is used simultaneously.…”

Pregabalin does not affect fracture healing adversely

“…As an adjunct drug for reducing postoperative pain, it may also be administered in surgically treated patients. [4,5] However, to the best of our knowledge, the effects of pregabalin on fracture healing have not been evaluated yet.…”

Coadyuvantes farmacológicos con efecto ahorrador de opioides en el periodo perioperatorio

“…Curiosamente, los autores no encontraron diferencias significativas en los resultados del dolor agudo al comparar los regímenes de una sola administración preoperatoria de pregabalina (100-300 mg) a la administración posoperatoria repetida (22). Dos metanálisis posteriores también encontraron disminuciones en el consumo de opioides perioperatorios con pregabalina (23,24). En una reciente revisión sistemática se incluyeron ensayos clínicos aleatorizados que investigaron el tratamiento de pregabalina perioperatoria en pacientes quirúrgicos adultos.…”