Pregabalin and pain after total knee arthroplasty: a double-blind, randomized, placebo-controlled, multidose trial †

YaDeau, Jacques T.; Lin, Yi Hsin; Mayman, David J.; Goytizolo, Enrique A.; Alexiades, Michael M.; Padgett, Douglas E.; Kahn, Richard L.; Jules-Elysée, Kethy M.; Ranawat, Amar S.; Bhagat, Devan D.; Fields, Kara G.; Goon, Amanda K.; Curren, Jodie; Westrich, Geoffrey H.

doi:10.1093/bja/aev217

Cited by 68 publications

(64 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A study by YaDeau et al41 found that pregabalin, as a component of a multimodal pain regimen, did not reduce pain, increased sedation, and decreased patient satisfaction. Therefore, pregabalin was found to have no beneficial effect.…”

Section: Multimodal Analgesiamentioning

confidence: 99%

Anesthesia for the patient undergoing total knee replacement: current status and future prospects

Turnbull

Sastow

Giambrone

et al. 2017

LRA

View full text Add to dashboard Cite

Total knee arthroplasty (TKA) has become one of the most common orthopedic surgical procedures performed nationally. As the population and surgical techniques for TKAs have evolved over time, so have the anesthesia and analgesia used for these procedures. General anesthesia has been the dominant form of anesthesia utilized for TKA in the past, but regional anesthetic techniques are on the rise. Multiple studies have shown the potential for regional anesthesia to improve patient outcomes, such as a decrease in intraoperative blood loss, length of stay, and patient mortality. Anesthesiologists are also moving toward multimodal analgesia, which includes peripheral nerve blockade, periarticular injection, and preemptive analgesia. The goal of multimodal analgesia is to improve perioperative pain control while minimizing systemic narcotic consumption. With improved postoperative pain management and rapid patient rehabilitation, new clinical pathways have been engineered to fast track patient recovery after orthopedic procedures. The aim of these clinical pathways was to improve quality of care, minimize unnecessary variations in care, and reduce cost by using streamlined procedures and protocols. The future of TKA care will be formalized clinical pathways and tracks to better optimize perioperative algorithms with regard to pain control and perioperative rehabilitation.

show abstract

Section: Multimodal Analgesiamentioning

confidence: 99%

Anesthesia for the patient undergoing total knee replacement: current status and future prospects

Turnbull

Sastow

Giambrone

et al. 2017

LRA

View full text Add to dashboard Cite

show abstract

“…Though lower plasma GABA level had a significant independent association with POD [75], a perioperative course of gabapentin produced only a clinically insignificant improvement in analgesia, but was associated with a higher incidence of sedation [76]. Pregabalin had no beneficial effects after total knee arthroplasty, either, but increased drowsiness and confusion [77]. Steroids (methylprednisolon or dexamethasone) did not affect the risk of POD in two large RCTs in cardiac surgery [78,79].…”

Section: Pharmacological Treatmentmentioning

confidence: 99%

Patients prone for postoperative delirium

Guenther

Riedel

Radtke

2016

Current Opinion in Anaesthesiology

View full text Add to dashboard Cite

An increase of the proportion of elderly patients undergoing surgery will lead to a higher incidence of POD. Preoperative assessment should facilitate identification of patients at high risk. Perioperative management should include monitoring depth of anesthesia, preference for nonopioid pain therapy, early regular delirium monitoring starting in the recovery room, avoiding ICU-sedation, early mobilization and exercise, and cognitive training.

show abstract

“…These studies used a single very small dose of pregabalin (up to 5 mg/kg) given before surgery. However, these trials failed to confer a significant reduction of chronic postsurgical pain [17,18] . When this failure is considered in light of the present results, it may be possible that an effective preemptive analgesia would necessitate the administration of higher doses of pregabalin than the one tried, repeated over several days PRE.…”

Section: Discussionmentioning

confidence: 99%

Oral Administration of Pregabalin in Rats before or after Nerve Injury Partially Prevents Spontaneous Neuropathic Pain and Long Outlasts the Treatment Period

Wang

Lou²,

Yu³

et al. 2016

Pharmacology

View full text Add to dashboard Cite

Background and Methods: Pregabalin alleviates stimulus-evoked neuropathic pain (NeuP) in some pain patients and rodents in models of painful neuropathies. But it is not known if pregabalin can also alleviate spontaneous NeuP. Sciatic and saphenous neurectomy in rats elicits spontaneous self-mutilation of the denervated hindpaw, a behavior that models spontaneous NeuP. We tested if pregabalin (20 or 30 mg/kg/day; twice daily, per os) for 7 days before denervation, or 42 days thereafter, can suppress this behavior. Results: Compared with the vehicle, pregabalin administered in both treatment regimens markedly and significantly delayed autotomy onset and suppressed its levels for weeks after treatment cessation. Conclusions: At doses known to effectively suppress stimulus-evoked pain in rats, pregabalin can prevent development of spontaneous NeuP and suppress it postoperatively.

show abstract

Pregabalin and pain after total knee arthroplasty: a double-blind, randomized, placebo-controlled, multidose trial †

Abstract: ClinicalTrials.gov: http://www.clinicaltrials.gov/ct2/show/study/NCT01333956.

Cited by 68 publications

References 29 publications

Anesthesia for the patient undergoing total knee replacement: current status and future prospects

Anesthesia for the patient undergoing total knee replacement: current status and future prospects

Patients prone for postoperative delirium

Oral Administration of Pregabalin in Rats before or after Nerve Injury Partially Prevents Spontaneous Neuropathic Pain and Long Outlasts the Treatment Period

Contact Info

Product

Resources

About