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From the *Department of Anesthesiology, Baystate Medical Center, Springfield, Massachusetts; and Department of Anesthesiology, Rush Medical College, Chicago, Illinois.
Address correspondence and reprint requests to Dr. Reuben, Department of Anesthesiology, Baystate Medical Center, 759 Chestnut St., Springfield, MA 01199. Address e-mail to scott.reuben{at}bhs.org.
Abstract
BACKGROUND: As optimal pain relief after surgery is difficult to achieve with the use of just one drug, many pain experts advocate the use of two or more classes of medications so as to reduce the side effects from any one drug. In this trial, we assessed the analgesic efficacy of administering perioperative celecoxib, pregabalin, or both after spinal fusion surgery.
METHODS: Eighty patients scheduled to undergo elective decompressive lumbar laminectomy with posterior spinal fusion were randomized to receive oral medications: placebo 1 h before and 12 h after surgery, celecoxib 400 mg 1 h before and celecoxib 200 mg 12 h after surgery, pregabalin 150 mg 1 h before and 12 h after surgery, or a pregabalin/celecoxib combination of 400 mg/150 mg 1 h before and 200 mg/150 mg 12 h after surgery.
RESULTS: The pregabalin/celecoxib group consumed the least patient-controlled morphine. Celecoxib alone or pregabalin alone also reduced opioid use compared with placebo, but not as much as when combined. The pregabalin/celecoxib combination was the most effective treatment for reducing pain both at rest and with movement over the 24-h postoperative time period. Hemodynamics and respiratory rate did not differ among the four treatment groups. Fewer patients experienced nausea in the pregabalin/celecoxib group compared with that in the placebo group.
CONCLUSION: The perioperative administration of the combination of celecoxib and pregabalin improved analgesia and caused fewer side effects, than either analgesic drug alone after spinal fusion surgery.
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  R. Jokela, J. Ahonen, M. Tallgren, M. Haanpaa, and K. Korttila Premedication with pregabalin 75 or 150 mg with ibuprofen to control pain after day-case gynaecological laparoscopic surgery Br. J. Anaesth., June 1, 2008; 100(6): 834 - 840. [Abstract] [Full Text] [PDF]
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 S. S. Reuben, A. Buvenandran, B. Katz, and J. S. Kroin A Prospective Randomized Trial on the Role of Perioperative Celecoxib Administration for Total Knee Arthroplasty: Improving Clinical Outcomes Anesth. Analg., April 1, 2008; 106(4): 1258 - 1264. [Abstract] [Full Text] [PDF]
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N. M. Gajraj Pregabalin: Its Pharmacology and Use in Pain Management Anesth. Analg., December 1, 2007; 105(6): 1805 - 1815. [Abstract] [Full Text] [PDF]
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S. S. Reuben, E. F. Ekman, and D. Charron Evaluating the Analgesic Efficacy of Administering Celecoxib as a Component of Multimodal Analgesia for Outpatient Anterior Cruciate Ligament Reconstruction Surgery Anesth. Analg., July 1, 2007; 105(1): 222 - 227. [Abstract] [Full Text] [PDF]
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 S. S. Reuben and A. Buvanendran Preventing the Development of Chronic Pain After Orthopaedic Surgery with Preventive Multimodal Analgesic Techniques J. Bone Joint Surg. Am., June 1, 2007; 89(6): 1343 - 1358. [Abstract] [Full Text] [PDF]
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 P. F. White, O. Sacan, B. Tufanogullari, M. Eng, N. Nuangchamnong, and B. Ogunnaike Effect of short-term postoperative celecoxib administration on patient outcome after outpatient laparoscopic surgery: [Effet de l'administration postoperatoire a court terme de celecoxib sur l'evolution des patients apres une chirurgie par laparoscopie sans hospitalisation] Can J Anesth, May 1, 2007; 54(5): 342 - 348. [Abstract] [Full Text] [PDF]
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