Browse > Article
http://dx.doi.org/10.3344/kjp.2011.24.1.22

A Randomised, Placebo-controlled Trial of the Effects of Preoperative Pregabalin on Pain Intensity and Opioid Consumption following Lumbar Discectomy  

Hegarty, Dominic A. (Department of Anaesthesia, Intensive Care & Pain Medicine, Cork University Hospital)
Shorten, George D. (Department of Anaesthesia, Intensive Care & Pain Medicine, Cork University Hospital)
Publication Information
The Korean Journal of Pain / v.24, no.1, 2011 , pp. 22-30 More about this Journal
Abstract
Background: Pregabalin has been shown to have analgesic effect in acute pain models. The primary objective was to examine the efficacy a single dose of pregabalin, would have on morphine consumption following lumbar discectomy. Methods: With ethical approval a randomized, placebo-controlled prospective trial was undertaken in 32 patients (ASA I-II, 18-65 years) with radicular low back pain for > 3 months undergoing elective lumbar discectomy. Patients received either oral pregabalin 300 mg (PG Group) or placebo (C Group) one hour before surgery. Pain intensity, the accumulative morphine consumption and adverse effects were recorded for 24 hours following surgery. Functional, psychological and quantitative sensory testing were also assessed. Results: Fourteen patients out of the 32 recruited were randomized to receive pregabalin. Morphine consumption was reduced (absolute difference of 42.3%) between groups with medium effect size. (Mann-Whitney; U =52.5, z-score= 2.84, P = 0.004, r = 0.14). This was not associated with a significant difference in the incidence of adverse effects between the two groups. The median pain intensity (VAS) on movement was not significantly different between groups. Conclusions: A single pre-operative dose of pregabalin (300 mg) did not result in a reduction in pain intensity compared to placebo in this patient cohort but the significant reduction in morphine consumption suggests that a fixed peri-operative dosing regime warrants investigation.
Keywords
morphine consumption; post-operative pain; pregabalin;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Tuchman M, Barrett JA, Donevan S, Hedberg TG, Taylor CP. Central sensitization and Ca(V)${\alpha}_2{\delta}$ ligands in chronic pain syndromes: pathologic processes and pharmacologic effect. J Pain 2010; 11: 1241-9.   DOI   ScienceOn
2 Jokela R, Ahonen J, Tallgren M, Haanpaa M, Korttila K. A randomized controlled trial of perioperative administration of pregabalin for pain after laparoscopic hysterectomy. Pain 2008; 134: 106-12.   DOI
3 Mathiesen O, Jacobsen LS, Holm HE, Randall S, Adamiec-Malmstroem L, Graungaard BK, et al. Pregabalin and dexamethasone for postoperative pain control: a randomized controlled study in hip arthroplasty. Br J Anaesth 2008; 101: 535-41.   DOI   ScienceOn
4 Buvanendran A, Kroin JS, Della Valle CJ, Kari M, Moric M, Tuman KJ. Perioperative oral pregabalin reduces chronic pain after total knee arthroplasty: a prospective, randomized, controlled trial. Anesth Analg 2010; 110: 199-207.   DOI   ScienceOn
5 Straube S, Derry S, McQuay HJ, Moore RA. Enriched enrollment: definition and effects of enrichment and dose in trials of pregabalin and gabapentin in neuropathic pain. A systematic review. Br J Clin Pharmacol 2008; 66: 266-75.   DOI
6 Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand 1983; 67: 361-70.   DOI   ScienceOn
7 Bjelland I, Dahl AA, Haug TT, Neckelmann D. The validity of the hospital anxiety and depression scale. An updated literature review. J Psychosom Res 2002; 52: 69-77.   DOI   ScienceOn
8 Sullivan MJ, Lynch ME, Clark AJ. Dimensions of catastrophic thinking associated with pain experience and disability in patients with neuropathic pain conditions. Pain 2005; 113: 310-5.   DOI   ScienceOn
9 Agarwal A, Gautam S, Gupta D, Agarwal S, Singh PK, Singh U. Evaluation of a single preoperative dose of pregabalin for attenuation of postoperative pain after laparoscopic cholecystectomy. Br J Anaesth 2008; 101: 700-4.   DOI   ScienceOn
10 Taylor CP. Mechanisms of analgesia by gabapentin and pregabalin--calcium channel alpha2-delta [Cavalpha2-delta] ligands. Pain 2009; 142: 13-6.   DOI   ScienceOn
11 Hill CM, Balkenohl M, Thomas DW, Walker R, Mathe H, Murray G. Pregabalin in patients with postoperative dental pain. Eur J Pain 2001; 5: 119-24.
12 Ostelo RW, de Vet HC, Knol DL, van den Brandt PA. 24-item Roland-Morris disability questionnaire was preferred out of six functional status questionnaires for post-lumbar disc surgery. J Clin Epidemiol 2004; 57: 268-76.   DOI   ScienceOn
13 Paech MJ, Goy R, Chua S, Scott K, Christmas T, Doherty DA. A randomized, placebo-controlled trial of preoperative oral pregabalin for postoperative pain relief after minor gynecological surgery. Anesth Analg 2007; 105: 1449-53.   DOI   ScienceOn
14 Nemethy M, Paroli L, Williams-Russo PG, Blanck TJ. Assessing sedation with regional anesthesia: inter-rater agreement on a modified Wilson sedation scale. Anesth Analg 2002; 94: 723-8.   DOI   ScienceOn
15 Melzack R. The McGill pain questionnaire: from description to measurement. Anesthesiology 2005; 103: 199-202.   DOI   ScienceOn
16 Kehlet H, Wilmore DW. Multimodal strategies to improve surgical outcome. Am J Surg 2002; 183: 630-41.   DOI   ScienceOn
17 Apfelbaum JL, Chen C, Mehta SS, Gan TJ. Postoperative pain experience: results from a national survey suggest postoperative pain continues to be undermanaged. Anesth Analg 2003; 97: 534-40.   DOI   ScienceOn
18 Kehlet H, Jensen TS, Woolf CJ. Persistent postsurgical pain: risk factors and prevention. Lancet 2006; 367: 1618-25.   DOI   ScienceOn
19 Buvanendran A, Kroin JS, Kari M, Tuman KJ. Can a single dose of 300 mg of pregabalin reach acute antihyperalgesic levels in the central nervous system? Reg Anesth Pain Med 2010; 35: 535-8.   DOI   ScienceOn