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PAIN MEDICINE

A Randomized, Placebo-Controlled Trial of Preoperative Oral Pregabalin for Postoperative Pain Relief After Minor Gynecological Surgery

Michael J. Paech, DM^*, Raymond Goy, FANZCA, Sebastian Chua, MMed, Karen Scott, FRCA, Tracey Christmas, MRCP, and Dorota A. Doherty, PhD

From the *Pharmacology and Anaesthesiology Unit, School of Medicine and Pharmacology, The University of Western Australia; Department of Anaesthesia and Pain Medicine, King Edward Memorial Hospital for Women; and Research Design and Biostatistics Unit, Women and Infants Research Foundation, Perth, Western Australia, Australia.

Address correspondence to Prof. Michael Paech, Department of Anaesthesia and Pain Medicine, King Edward Memorial Hospital for Women, 374 Bagot Rd., Subiaco, Western Australia 6008, Australia. Address e-mail to michael.paech{at}health.wa.gov.au

BACKGROUND: Although pregabalin shows efficacy against neuropathic pain, very limited evidence supports postoperative analgesic efficacy. Our study objective was to investigate analgesic efficacy in an ambulatory day surgical population experiencing acute visceral pain. The null hypothesis was that there was no significant difference in pain relief between pregabalin and placebo.

METHODS: A randomized, double-blind, parallel-group, placebo-controlled trial was performed in 90 women having minor gynecological surgery involving the uterus. Patients received either oral pregabalin 100 mg (Group PG) or placebo (Group C) approximately 1 h before surgery. The primary outcome was pain score in the recovery unit and patients were followed for 24 h.

RESULTS: There was no significant difference between groups for pain experienced in the recovery room (median, interquartile range 16, 0–36 vs 10, 6.5–36 for Groups PG and C, respectively, P = 0.80) or thereafter; nor for recovery room fentanyl requirement (42% Group PG versus 27% Group C, P = 0.12) or the quality of recovery at 24 h postoperatively (median, interquartile range score 17, 17–18 Group PG versus 18, 16.5–18 Group C, P = 0.75). The incidence of posthospital discharge light-headedness, visual disturbance, and difficulty with walking was significantly higher in the pregabalin group.

CONCLUSIONS: A single preoperative dose of 100 mg pregabalin does not reduce acute pain or improve recovery after minor surgery involving only the uterus.

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