Use of low-dose pregabalin in patients undergoing laparoscopic cholecystectomy

• Published in: British journal of anaesthesia : BJA Vol. 105; no. 2; pp. 155 - 161
• Main Authors: Peng, P.W.H., Li, C, Farcas, E, Haley, A, Wong, W, Bender, J, Chung, F
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01-08-2010; Oxford University Press
• Subjects: Adolescent; Adult; Aged; Ambulatory Surgical Procedures; anaesthesia; Analgesics, Non-Narcotic - administration & dosage; Analgesics, Non-Narcotic - adverse effects; Analgesics, Opioid - administration & dosage; Anesthesia; Anesthesia, General - methods; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; cholecystectomy; Cholecystectomy, Laparoscopic; Dose-Response Relationship, Drug; Double-Blind Method; Drug Administration Schedule; gamma-Aminobutyric Acid - administration & dosage; gamma-Aminobutyric Acid - adverse effects; gamma-Aminobutyric Acid - analogs & derivatives; general surgery; Humans; Medical sciences; Middle Aged; pain; Pain Measurement - methods; pain, postoperative; Pain, Postoperative - prevention & control; postoperative; Pregabalin; premedication; Premedication - methods; Prospective Studies; general surgery; pregabalin; cholecystectomy; premedication; anaesthesia; pain, postoperative; Cholecystectomy; Human; Postoperative; General surgery; Low dose; Anticonvulsant; Pregabalin; Analgesic; Pain; Anesthesia
• ISSN: 0007-0912; 1471-6771
• DOI: 10.1093/bja/aeq116

The objective of this study was to examine the effects of low-dose pregabalin on the analgesic efficacy, side-effects, and recovery profile in patients undergoing laparoscopic cholecystectomy.
One hundred and sixty-two patients aged 18–65 yr, of ASA physical status I–III, undergoing elective outpatient laparoscopic cholecystectomy were recruited and randomized in this prospective, placebo-controlled, double-blind study to receive one of the following study medications orally: pregabalin 50 mg, pregabalin 75 mg, or placebo, 1 h before surgery and then every 12 h after operation for a total of three doses. Postoperative numeric pain scores, analgesic consumption, recovery score (QoR-40), and side-effects (opioid-related symptom distress scale) were assessed in the early postoperative period (every 15 min during the first hour, at 90, 120 min, 6, and 12 h) and at days 1, 2, and 7. Data were analysed using an intention-to-treat method.
Compared with the placebo group, the pain scores were lower in the pregabalin 75 mg group in the first 90 min after surgery (P<0.05). Pregabalin 50 mg resulted in pain reduction at 30 and 45 min (P<0.05) relative to placebo. The analgesic consumption, side-effects, and recovery scores were similar among the three groups.
Perioperative administration of pregabalin 75 mg provided limited analgesic benefit in the postoperative period. An updated meta-analysis confirms this finding (see Supplementary material).