Pregabalin Effect on Acute and Chronic Pain after Cardiac Surgery

Abstract

Introduction. Pain after cardiac surgery affects long-term patient wellness. This study investigated the effect of preoperative pregabalin on acute and chronic pain after elective cardiac surgery with median sternotomy. Methods. Prospective double blind study. 93 cardiac surgery patients were randomly assigned into three groups: Group 1 received placebo, Group 2 received oral pregabalin 75 mg, and Group 3 received oral pregabalin 150 mg. Data were collected 8 hours, 24 hours, and 3 months postoperatively. Results. Patients receiving pregabalin required fewer morphine boluses (10 in controls versus 6 in Group 1 versus 4 in Group 2, p = 0.000) and had lower pain scores at 8 hours (4 versus 3 versus 3, p = 0.001) and 3 months (3 versus 2 versus 2, p = 0.000) and lower morphine consumption at 8 hours (14 versus 13 versus 12 mg, p = 0.000) and 24 hours (19.5 versus 16 versus 15 mg, p = 0.000). Percentage of patients with sleep disturbances or requiring analgesics was lower in the pregabalin group and even lower with higher pregabalin dose (16/31 versus 5/31 versus 3/31, p = 0.000, and 26/31 versus 16/31 versus 10/31, p = 0.000, resp.) 3 months after surgery. Conclusion. Preoperative oral pregabalin 75 or 150 mg reduces postoperative morphine requirements and acute and chronic pain after cardiac surgery.

Oral Pregabalin in Cardiac Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

“…For the remaining 9 articles, two of them were excluded for the reason: meta-analysis [15] and commentary [16]. Finally, the remained 7 studies [17][18][19][20][21][22][23] with available data met our selection criteria and were included in the systematic review. The flow diagram of search strategy and study selection was presented in Figure 1.…”

“…No significant side effects were found on pregabalin applied to cardiac surgery patients (Table 1). [20][21][22]. Heterogeneity was noted among the three studies (I 2 = 97%; P < 0:00001), and a randomized-effects model was selected.…”

Enhanced recovery after cardiac surgery

“…The side effects, such as somnolence and dizziness, are less common compared to gabapentin. The mechanism of action of gabapentinoids involves the modulation of ion flow in the calcium channels, limiting the central susceptibility by reducing the release of transmitters [9]. Another drug that can limit cognitive and sleep disorders is melatonin, which can be used for premedication [10].…”

Comment on “Pregabalin Effect on Acute and Chronic Pain after Cardiac Surgery”

“…We have read with great interest the article entitled “ Clinical Study: Pregabalin Effect on Acute and Chronic Pain after Cardiac Surgery” by Bouzia et al [1]. We appreciate their effort for this clinical study, and we would like to make some comments as we believe that there are some flaws in its design and methodology.…”