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The effect of pregabalin and celecoxib on the analgesic requirements after laparoscopic cholecystectomy: a randomized controlled trial

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Abstract

Purpose

Early postoperative pain is a common complaint after elective laparoscopic cholecystectomy. The use of non-opioid medications as a part of multimodal analgesia has been increasingly advocated in the management of acute post-surgical pain. This randomized, double-blinded, placebo-controlled study evaluated the efficacy of pregabalin, celecoxib, and their combination in the management of acute postoperative pain in patients undergoing elective laparoscopic cholecystectomy.

Methods

One hundred ASA I/II patients scheduled to undergo elective laparoscopic cholecystectomy were assigned to receive two perioperative doses, 12 h apart, of either pregabalin alone, celecoxib alone, their combination, or a placebo. Standard anesthetic protocol was followed. The primary outcomes were postoperative pain at rest and with movement. Secondary outcomes were fentanyl requirements and side effects, which were assessed at 1, 2, 4, 8, 12, and 24 h following surgery. Patient satisfaction with pain relief was recorded at discharge. Differences in main outcomes were analyzed using an intention-to-treat approach.

Results

There was no statistically significant difference (p > 0.05) between the four groups in terms of outcomes such as rest pain, movement pain, postoperative fentanyl requirements, or changes in anxiety scores. Patients who had only celecoxib had significantly higher satisfaction with pain management (p = 0.013). Patients who had only pregabalin were at three-times-higher odds of having drowsiness (p = 0.040) and four-times-higher odds of having lightheadedness (p = 0.019) when compared with the placebo group.

Conclusions

Pregabalin, celecoxib alone, or in combination offers no analgesic superiority over standard opioid care in the treatment of postoperative pain following laparoscopic cholecystectomy.

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Acknowledgments

We would like to thank the staff at the pharmacy and surgical preadmission clinic services, The Prince Charles Hospital, Brisbane, for supporting this study. We also acknowledge the assistance from Ms. Denise Rossiter and Dr. Kate E. Berry during the data collection process.

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Authors and Affiliations

  1. Department of Anesthesia and Perfusion Services, The Prince Charles Hospital and School of Medicine, University of Queensland, Brisbane, Australia

    Usha Gurunathan & Ivan L. Rapchuk

  2. Surgical Preadmission Clinic, The Prince Charles Hospital, Brisbane, Australia

    Gillian King

  3. Queensland University of Technology, Brisbane, Australia

    Adrian G. Barnett

  4. Intensive Care Unit, CCRG, The Prince Charles Hospital, University of Queensland, Brisbane, Australia

    John F. Fraser

Authors
  1. Usha Gurunathan
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  2. Ivan L. Rapchuk
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  3. Gillian King
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  5. John F. Fraser
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Corresponding author

Correspondence to Usha Gurunathan.

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Funding

This research was funded by a grant from The Prince Charles Hospital Foundation, Grant No. NR2012-126.

Conflict of interest

The authors declare that they have no competing interests.

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Gurunathan, U., Rapchuk, I.L., King, G. et al. The effect of pregabalin and celecoxib on the analgesic requirements after laparoscopic cholecystectomy: a randomized controlled trial. J Anesth 30, 64–71 (2016). https://doi.org/10.1007/s00540-015-2078-9

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  • DOI: https://doi.org/10.1007/s00540-015-2078-9

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