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Effect of pre-emptive pregabalin on pain intensity and postoperative morphine consumption after laparoscopic cholecystectomy

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Abstract

Background

Postoperative pain is the dominant complaint and the most common cause of delayed discharge after laparoscopic cholecystectomy. The aim of this study is to evaluate the potential of preoperative administration of pregabalin to reduce postoperative pain and opioid consumption.

Methods

Fifty American Society of Anesthesiologists (ASA) I and II adult patients with symptomatic gallstone disease scheduled for elective laparoscopic cholecystectomy were randomized into two groups: group I patients (n = 25) were given 600 mg pregabalin per os divided in two doses, the night before surgery and 1 h preoperatively, respectively, while group II patients (n = 25) received a matching to pregabalin placebo at the same scheme. Postoperative pain, morphine consumption, and complications were compared between the two groups.

Results

Postoperative pain (static and dynamic assessment) was significantly less at 0, 1, 8, 16, and 24 h (p < 0.001) after the procedure for group I (pregabalin) compared with the placebo group. Postoperative patient-controlled morphine consumption during hospital stay was also significantly less in the pregabalin group compared with the placebo group. Side-effects were similar in both groups expect for dizziness, which was significantly higher (p < 0.0001) in the pregabalin group.

Conclusions

Administration of 600 mg pregabalin per os, divided in two preoperative doses, significantly reduces postoperative pain as well as opioid consumption in patients undergoing laparoscopic cholecystectomy, at the cost of increased incidence of dizziness.

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References

  1. Bisgaard T (2006) Analgesic treatment after laparoscopic cholecystectomy. A critical assessment of the evidence. Anesthesiology 104:835–846

    Article  PubMed  Google Scholar 

  2. Bisgaard T, Kehlet H, Rosenberg J (2001) Pain and convalescence after laparoscopic cholecystectomy. Eur J Surg 167:84–96

    Article  PubMed  CAS  Google Scholar 

  3. Gajraj NM (2007) Pregabalin: its pharmacology and use in pain management. Anesth Analg 105:1805–1815

    Article  PubMed  CAS  Google Scholar 

  4. Abhishek B, Anurag T, Shuchit AlkaG (2009) Pregabalin: pharmacology and use in pain management. J Anaesth Clin Pharmacol 25:321–326

    Google Scholar 

  5. Guay DR (2005) Pregabalin in neuropathic pain: a more ‘pharmaceutically elegant’ gabapentin? Am J Geriatr Pharmacother 3:274–287

    Article  PubMed  CAS  Google Scholar 

  6. Przesmycki K, Wiater-Kozioł E, Kotarski J, Czuczwar M, Jaskowiak R et al (2011) Effect of pre-emptive pregabalin on pain intensity and morphine requirement after hysterectomy. Anestezjol Intens Ter 43:14–17

    PubMed  Google Scholar 

  7. Gianesello L, Pavoni V, Barboni E, Galeotti I, Nella A (2011) Perioperative pregabalin for postoperative pain control and quality of life after major spinal surgery. J Neurosurg Anesthesiol 24(2):121–126

    Article  Google Scholar 

  8. Gonano C, Latzke D, Sabeti-Aschraf M, Kettner SC, Chiari A, Gustorff B (2011) The anxiolytic effect of pregabalin in outpatients undergoing minor orthopaedic surgery. J Psychopharmacol 25:249–253

    Article  PubMed  CAS  Google Scholar 

  9. Jokela R, Ahonen J, Tallgren M, Haanpää M, Korttila K (2008) A randomized controlled trial of perioperative administration of pregabalin for pain after laparoscopic hysterectomy. Pain 134:106–112

    Article  PubMed  CAS  Google Scholar 

  10. White PF, Tufanogullari B, Taylor J, Klein K (2009) The effect of pregablin on preoperative anxiety and sedation levels: a dose ranging study. Anesth Analg 108:1140–1145

    Article  PubMed  CAS  Google Scholar 

  11. Chang SH, Lee HW, Kim SH, Kim DK (2009) An evaluation of perioperative pregabalin for prevention and attenuation of postoperative shoulder pain after laparoscopic cholecystectomy. Anesth Analg 109:1284–1286

    Article  PubMed  Google Scholar 

  12. Mathiesen O, Rasmussen ML, Dierking G, Lech K, Hilsted KL, Fomsgaard JS et al (2009) Pregabalin and dexamethasone in combination with paracetamol for postoperative pain control after abdominal hysterectomy. A randomized clinical trial. Acta Anaesthesiol Scand 53:227–235

    Article  PubMed  CAS  Google Scholar 

  13. Paech MJ, Goy R et al (2007) A randomized, placebo-controlled trial of preoperative oral pregabalin for postoperative pain relief after minor gynecological surgery. Anesth Analg 105:1449–1453

    Article  PubMed  CAS  Google Scholar 

  14. Balaban F, Yağar S, Özgök A, Koç M (2012) Güllapoğlu H. A randomized, placebo-controlled study of pregabalin for postoperative pain intensity after laparoscopic cholecystectomy J Clin Anesth 24:175–178

    CAS  Google Scholar 

  15. Pesonen A, Suojaranta-Ylinen R (2011) Hammare‘n E, Kontinen V.K., Raivio P, et al. Pregabalin has an opioid-sparing effect in elderly patients after cardiac surgery: a randomized placebo-controlled trial. Br J Anaesth 106:873–881

    Article  PubMed  CAS  Google Scholar 

  16. Kim SY, Jeong JJ, Chung WY, Kim HJ, Nam KH, Shim YH (2010) Perioperative administration of pregabalin for pain after robot-assisted endoscopic thyroidectomy: a randomized clinical trial. Surg Endosc 24:2776–2781

    Article  PubMed  Google Scholar 

  17. Schulmeyer MC, Maza J, Ovalle C, Farias CI (2009) Analgesic effects of a single preoperative dose of pregabalin after laparoscopic sleeve gastrectomy. Οbes Surg 20:168–1678

    Google Scholar 

  18. Ittichaikulthol W et al (2009) Effects of pregabalin on post operative morphine consumption and pain after abdominal hysterectomy with/without salphingo-oophorectomy: a randomized, double-blind trial. J Med Assoc Thai 92:1318–1323

    PubMed  Google Scholar 

  19. Agarwal A, Gautam S, Gupta D, Agarwal S, Singh PK, Singh U (2008) Evaluation of a single preoperative dose of pregabalin for attenuation of postoperative pain after laparoscopic cholecystectomy. Br J Anaesth 101:700–704

    Article  PubMed  CAS  Google Scholar 

  20. Freedman BM, O’Hara E (2008) Pregabalin has opioid sparing-effects following augmentation mammaplasty. Aesthet Surg J 28:421–424

    Article  PubMed  Google Scholar 

  21. Peng PW, Li C, Farcas E, Haley A, Wong W, Bender J, Chung F (2010) Use of low-dose pregabalin in patients undergoing laparoscopic cholecystectomy. Br J Anaesth 105:155–161

    Article  PubMed  CAS  Google Scholar 

  22. Jokela R, Ahonen J, Tallgren M, Haanpaa M, Korttila K (2008) A randomized controlled trial of perioperative administration of pregabalin for pain after laparoscopic hysterectomy. Pain 134:106–112

    Article  PubMed  CAS  Google Scholar 

  23. Jokela R, Ahonen J, Tallgren M, Haanpa M, Korttila K (2008) Premedication with pregabalin 75 or 150 mg with ibuprofen to control pain after day-case gynaecological laparoscopic surgery. Br J Anaesth 100:834–840

    Article  PubMed  CAS  Google Scholar 

  24. Mathiesen O, Jacobsen LS, Holm HE, Randall S, Adamiec-Malmstroem L, Graungaard BK, Holst PE, Hilsted KL, Dahl JB (2008) Pregabalin and dexamethasone for postoperative pain control: a randomized controlled study in hip arthroplasty. Br J Anaesth 101:535–541

    Article  PubMed  CAS  Google Scholar 

  25. Trabulsi EJ, Patel J, Viscusi ER, Gomella LG, Lallas C (2010) Preemptive multimodal pain regimen reduces opioid analgesia for patients undergoing robotic-assisted laparoscopic radical prostatectomy. Urology 76:1122–1124

    Article  PubMed  Google Scholar 

  26. Gilron I (2007) Gabapentin and pregabalin for chronic neuropathic and early postsurgical pain: current evidence and future directions. Curr Opin Anaesthesiol 20:456–472

    Article  PubMed  Google Scholar 

  27. Kindler CH, Harms C, Amsler F, Scholl T, Scheidegger D (2000) The visual analog scale allows effective measurement of preoperative anxiety and detection of patients’ anesthetic concerns. Anesth Analg 90:706–712

    Article  PubMed  CAS  Google Scholar 

  28. Zhang J, Ho K-Y, Wang Y (2011) Efficacy of pregabalin in acute postoperative pain: a meta-analysis. Br J Anaesth 106:454–462

    Article  PubMed  CAS  Google Scholar 

  29. Romundstad L, Breivik H, Roald H et al (2006) Methylprednisolone reduces pain, emesis, and fatigue after breast augmentation surgery: a single-dose, randomized, parallel-group study with methylprednisolone 125 mg, parecoxib 40 mg, and placebo. Anesth Analg 102:418–425

    Article  PubMed  CAS  Google Scholar 

  30. Bisgaard T, Klarskov B, Rosenberg J, Kehlet H (2001) Characteristics and prediction of early pain after laparoscopic cholecystectomy. Pain 90:261–269

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Chamaidi Sarakatsianou.

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Sarakatsianou, C., Theodorou, E., Georgopoulou, S. et al. Effect of pre-emptive pregabalin on pain intensity and postoperative morphine consumption after laparoscopic cholecystectomy. Surg Endosc 27, 2504–2511 (2013). https://doi.org/10.1007/s00464-012-2769-3

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  • DOI: https://doi.org/10.1007/s00464-012-2769-3

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