The Effectiveness of Pregabalin for Post-Tonsillectomy Pain Control: A Randomized Controlled Trial

Abstract

BackgroundAlthough various analgesics have been used, postoperative pain remains one of the most troublesome aspects of tonsillectomy for patients.ObjectiveThe aim of the present study was to evaluate the effectiveness of premedication using pregabalin compared with placebo (diazepam) on postoperative pain control in patients undergoing tonsillectomy.MethodsForty-eight adult patients were randomly divided into a control group and a pregabalin group. Preoperatively, patients in the control group received 4 mg diazepam orally as placebo, whereas those in the pregabalin group received 300 mg pregabalin orally. All participants were provided with patient-controlled analgesia using fentanyl for 24 hours after surgery. Postoperative pain treatment included acetaminophen 650 mg three times daily for 8 postoperative days. The primary outcome measure was the total amount of patient-controlled fentanyl consumption after tonsillectomy. Secondary outcome measures were the number of injections of ketorolac tromethamine (each 30 mg) requested by patients, pain scores, overall satisfaction scores, drowsiness, nausea, dizziness, headache, and vomiting after the surgery. P < 0.05 was considered statistically significant.ResultsThe total amount of fentanyl demanded decreased significantly in the pregabalin group (P < 0.001). There were no significant differences in the number of ketorolac tromethamine injections, pain scores, overall satisfaction scores, drowsiness, nausea, dizziness, headache, and vomiting between the two groups.ConclusionAdministration of 300 mg pregabalin prior to tonsillectomy decreases fentanyl consumption compared with that after 4 mg diazepam, without an increased incidence of adverse effects.Trial Registration KCT0001215

Preoperative Sedation, Hemodynamic Stability during General Anesthesia and Improving Postoperative Pain: Pregabalin Is the Answer

“…Open Journal of Anesthesiology In our study ketorolac and morphine consumption was significantly reduced in groups II and III compared with group I but there were no significant difference between groups II and III, indicating that preoperative pregabalin reduces postoperative analgesic consumption and that the dose of 150 mg is effective for this purpose. This finding agrees with those of Park et al, who found that fewer ketorolac injections were required in the pregabalin group than in the control group, but that the difference between the groups was not significant [25].…”

The efficacy of gabapentin/pregabalin in improving pain after tonsillectomy: A meta‐analysis

“…Regarding the issue of heterogeneity in the included studies, Park's study was a single outlying trial in the amounts of analgesic requirements during the postoperative period and Amin's study was a single outlying trial in the time to first analgesic administration. The noticeable things were that the SMD of Park et al and Amin et al were much larger than those of the summed SMD in the amount of analgesic requirements (−8.71 vs. −1.65) and the time to first analgesic administration (3.03 vs. 1.37), respectively.…”

“…Data from eligible studies were extracted using standardized forms and were independently checked by the two reviewers. Outcomes analyzed were postoperative pain (swallowing or resting pain scores after leaving the operation room), 2,6,8-12 postoperative (24 hours) analgesic requirements (either doses or percentage of patient receiving postoperative opioids or nonopioids analgesics), 2,6,[8][9][10]12,13 time to first analgesic administration (opioids or nonopioids analgesics administered with a defined pain intensity target), [9][10][11] time to first oral uptake, 2,5,12,13 the occurrence of postoperative nausea and vomiting (incidence or percentage of patients), 2,6,[8][9][10][11][12][13] dizziness, 6,8,12 and headache, 6,8,12 or sedation (sedation scores). 2,11 These outcomes were compared between the preoperative gabapentinoids group, in which there was intravenous and oral administration, and the control group, in which there was no treatment or use of opioids during the 24-hour postoperative period.…”

Pregabalin to improve postoperative recovery in bariatric surgery: a parallel, randomized, doubleblinded, placebo-controlled study

“…There are, however, other studies that investigated the postoperative analgesic efficacy of pregabalin and found variable results. 22 , 23 A randomized, placebo-controlled trial reported that a single preoperative dose of 100 mg pregabalin did not reduce acute pain or improve recovery after uterine surgery. The authors assigned the lack of result to the sub-therapeutic dose of pregabalin administered, as well as the type of surgery and pain mechanism.…”