Pregabalin reduces postoperative pain after thoracotomy


  • Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • Meta-analysis suggests pregabalin can relieve acute and chronic postoperative pain in patients undergoing thoracotomy and decrease the incidence of neuropathic pain and morphine consumption.

Why this matters

  • This is the first meta-analysis to evaluate pregabalin as an adjuvant to a perioperative multimodal analgesic regimen in thoracotomy.
  • The effectiveness of pregabalin in postoperative pain is controversial.

Study design

  • Meta-analysis of 9 randomised-controlled trials including 684 patients who received either pregabalin or conventional analgesia/placebo (control group).
  • Outcome: Postoperative pain scores and incidence of neuropathic pain.
  • Funding: The Medical Science Research Foundation of Zhejiang Province; The Natural Science Fund of Zhejiang Province; other.

Key results

  • Pregabalin significantly reduced postoperative pain scores at:
    • day 1 (mean difference [MD], −0.87; P=.01),
    • day 3 (MD, −1.55; P<.00001>
    • 1 month (MD, −1.58; P=.008),
    • 3 months (MD, −1.69; P=.001).
  • Pregabalin significantly reduced
    • the incidence of neuropathic pain by 80% (P=.04) and
    • mean morphine consumption (MD, −5.03; P=.001).
  • Pregabalin was associated with higher risk for dizziness (OR, 3.33; P=.009), drowsiness (OR, 8.61; P=.002) and lower incidence of constipation (OR, 0.23; P=.002).
  • No statistical differences were observed in pain score at day 7 (MD, −0.77; P=.35), nausea (OR, 0.73; P=.26) or vomiting (OR, 0.83; P=.65).

Limitations

  • Heterogeneity between studies.

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