Perioperative Pregabalin for Postoperative Pain Control and Quality of Life After Major Spinal Surgery
Journal of Neurosurgical Anesthesiology ,  Clinical Article

Gianesello L et al. – Perioperative pregabalin (PG) administration reduces early postsurgical pain at rest and particularly during movement after major spine surgery with less opioid consumption, and it seems to influence the improvement of overall quality of life (QoL) 3months after surgery.

Methods
  • Sixty patients scheduled for elective decompressive spine surgery were enrolled.
  • One hour before surgery patients received 300mg of either oral PG or placebo (PL) and 150mg of PG or PL twice a day for 48hours postoperatively.
  • During the first 48 postoperative hours, a continuous infusion of morphine 0.01mg/kg/h and ketorolac tromethamine 2.5mg/h was administered.
  • Intravenous morphine in 2–mg aliquots up to a maximum of 10mg was used as rescue therapy.
  • Pain was measured at rest and during movement using a visual analog scale (VAS score), and side effects were recorded in the first hour and at 4, 8, 12, 24, and 48hours.
  • Three months and 1year after discharge, patients were contacted by telephone by 1 of the authors to obtain follow–up information using the EuroQoL questionnaire.

Results
  • During the first 8 postoperative hours, VAS scores at rest were significantly lower in the PG group than in the PL group (P<0.05), whereas VAS scores on movement were significantly lower up to 12hours after the operation in the PG group (P<0.05).
  • The morphine consumption in the PG group was 3±2mg, whereas in the PL group it was 9.5±2.5mg (P<0.05).
  • Postoperative incidence of constipation and nausea/vomiting was higher in the PL group than in the PG group.
  • No significant differences between the 2 groups were observed with regard to other adverse effects.
  • QoL measures revealed an improvement in outcome, especially in movement and in pain dimensions in both groups; however, at 3months, subjective qualification of overall QoL was better in the PG group than in the PL group.
  • There were no differences in QoL after the 1–year follow–up period.

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