Perioperative Pregabalin for Attenuation of Postoperative Pain After Eyelid Surgery

Wei, Leslie A.; Davies, Brett W.; Hink, Eric M.; Durairaj, Vikram D.

doi:10.1097/iop.0000000000000219

Cited by 17 publications

(17 citation statements)

References 31 publications

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“…The major advantages of PGB include its relative reliability, ease of use, and high tolerability [ 26 ]. Thus far, it has been used for NeP associated with alterations in both the central nervous system (e.g., spinal cord injury) [ 23 ] and peripheral nervous system (postoperative pain) [ 27 – 32 ], and the current study proved that it is also effective in alleviating neuropathic leg pain and improving ADL/QOL, including sleep quality, in LSS patients. These findings indicate that persistent leg pain in LSS patients that is refractory to NSAIDs can be effectively controlled using PGB, which is initiated with a low dose that is gradually increased.…”

Section: Discussionmentioning

confidence: 53%

Pregabalin for Refractory Radicular Leg Pain due to Lumbar Spinal Stenosis: A Preliminary Prospective Study

Orita

Yamashita

Eguchi

et al. 2016

Pain Research and Management

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We investigated the efficacy of pregabalin (PGB) for neuropathic leg pain in lumbar spinal stenosis (LSS) patients with disturbed activities of daily living (ADL)/quality of life (QOL) in a prospective observational study. Subjects were a total of 104 LSS patients with neuropathic pain (NeP) in leg and neurological intermittent claudication (IMC) refractory to nonsteroidal anti-inflammatory drugs (NSAIDs) for at least a month. NeP was identified using screening tool, Pain DETECT questionnaire. Visual analog scale (VAS) scores and responses to the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) were assessed before and 6 weeks after PGB treatment initiation. Changes in IMC distance and adverse events were also recorded. PGB significantly improved their VAS scores for pain and sleep quality (P < 0.001). With respect to JOABPEQ, significant improvements were observed with regard to the following dimensions: pain-related disorders (P < 0.01), lumbar spine dysfunction (P = 0.031), gait disturbance (P = 0.028), and psychological disorders (P = 0.014). The IMC distance showed an improvement tendency after PGB treatment, albeit with no significance (P = 0.063). Minor adverse events such as dizziness were observed. PGB can be effective for neuropathic leg pain refractory to NSAIDs in LSS patients, resulting in not only pain control but also improving lower back pain-related ADL/QOL scores.

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Section: Discussionmentioning

confidence: 53%

Pregabalin for Refractory Radicular Leg Pain due to Lumbar Spinal Stenosis: A Preliminary Prospective Study

Orita

Yamashita

Eguchi

et al. 2016

Pain Research and Management

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“…Thirty-one studies had included data on nausea prevalence after pregabalin administration, 13 , 21 , 24 , 26 , 28 , 30 , 33 , 37 , 44 , 46 , 47 , 50 – 52 , 54 , 56 , 57 , 59 , 60 , 63 – 65 , 67 , 68 , 70 , 71 , 77 , 85 , 86 , 88 with a total of 1067 patients taking pregabalin and 1038 patients on the control treatment. It was found that there was no difference in nausea incidence in cardiothoracic surgery, ENT surgery, gynecologic surgery, laparoscopic cholecystectomy, and spine surgery between pregabalin and control treatment groups.…”

Section: Resultsmentioning

confidence: 99%

Efficacy of Pregabalin in Acute Postoperative Pain Under Different Surgical Categories

et al. 2015

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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.

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“…However, the exact mechanism through which GBT, by involving multiple players, exerts its analgesic effect is complex and not definitively clarified ( Taylor and Harris, 2020 ). In ocular neuropathies, systemic administration of GBT or its analog pregabalin has been demonstrated to reduce pain ( Lichtinger et al, 2011 ; Pakravan et al, 2012 ; Wei et al, 2015 ; Ongun and Ongun, 2019 ; Yoon et al, 2020 ), although its efficacy in counteracting ocular pain in patients with DED has been questioned ( Ozmen, 2020 ).…”

Section: Discussionmentioning

confidence: 99%

“…Analgesic drugs include gabapentin (GBT), a structural analog of gamma-amino butyric acid that has been introduced as an adjunctive therapy in epilepsy and is presently widely used to treat several kinds of neuropathic pain. The possibility that GBT may counteract ocular pain has been suggested by several studies ( Lichtinger et al, 2011 ; Pakravan et al, 2012 ; Wei et al, 2015 ; Ongun and Ongun, 2019 ; Yoon et al, 2020 ), since the first demonstration of systemic GBT efficacy in providing significant pain relief in glaucomatous patients ( Kavalieratos and Dimou, 2008 ). At least some of the clinical effects of GBT are due to high affinity interactions with the α2δ1 auxiliary subunit of presynaptic voltage-gated calcium channels ( Taylor and Harris, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Effects of Topical Gabapentin on Ocular Pain and Tear Secretion

Cammalleri

Amato

Olivieri³

et al. 2021

Front. Pharmacol.

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Neuropathic ocular pain is a frequent occurrence in medium to severe dry eye disease (DED). Only palliative treatments, such as lubricants and anti-inflammatory drugs, are available to alleviate patients’ discomfort. Anesthetic drugs are not indicated, because they may interfere with the neural feedback between the cornea and the lacrimal gland, impairing tear production and lacrimation. Gabapentin (GBT) is a structural analog of gamma-amino butyric acid that has been used by systemic administration to provide pain relief in glaucomatous patients. We have already shown in a rabbit model system that its topic administration as eye drops has anti-inflammatory properties. We now present data on rabbits’ eyes showing that indeed GBT given topically as eye drops has analgesic but not anesthetic effects. Therefore, opposite to an anesthetic drug such as oxybuprocaine, GBT does not decrease lacrimation, but–unexpectedly–even stimulates it, apparently through the upregulation of acetylcholine and norepinephrine, and by induction of aquaporin 5 (AQP5) expression in the lacrimal gland. Moreover, data obtained in vitro on a primary human corneal epithelial cell line also show direct induction of AQP5 by GBT. This suggests that corneal cells might also contribute to the lacrimal stimulation promoted by GBT and participate with lacrimal glands in the restoration of the tear film, thus reducing friction on the ocular surface, which is a known trigger of ocular pain. In conclusion, GBT is endowed with analgesic, anti-inflammatory and secretagogue properties, all useful to treat neuropathic pain of the ocular surface, especially in case of DED.

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Perioperative Pregabalin for Attenuation of Postoperative Pain After Eyelid Surgery

Abstract: Pregabalin is effective in reducing postoperative pain after oculoplastic procedures when compared with placebo. It may be a useful adjunct for pain control in selected patients.

Cited by 17 publications

References 31 publications

Pregabalin for Refractory Radicular Leg Pain due to Lumbar Spinal Stenosis: A Preliminary Prospective Study

Pregabalin for Refractory Radicular Leg Pain due to Lumbar Spinal Stenosis: A Preliminary Prospective Study

Efficacy of Pregabalin in Acute Postoperative Pain Under Different Surgical Categories

Effects of Topical Gabapentin on Ocular Pain and Tear Secretion

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