- Pregabalin given at the time of mastectomy to 7 postoperative days cuts the development of postmastectomy pain syndrome (PMPS) by 74% vs placebo.
Why this matters
- PMPS is a neuropathic pain condition that affects 10% to 40% of patients and negatively affects QoL.
- Randomized, double-blind, placebo-controlled clinical trial of pregabalin (n=100) or placebo (n=100) given as 75 mg twice daily from the time of induction of anesthesia to postoperative day 7 in patients with breast cancer undergoing mastectomy.
- The primary outcome was rate of PMPS diagnosis at 12 weeks, with PMPS diagnosed by clinical criteria (neuropathic pain involving the anterior aspect of the chest, axilla, and/or upper arm that persists continuously or intermittently for ≥3 months).
- Funding: None disclosed.
- The pregabalin group (vs placebo) had less frequent neuropathic pain (Grading System for Neuropathic Pain, ≥grade 3) at 4 weeks (P=.005), 12 weeks (P=.002), and 24 weeks (P<.001>
- The pregabalin group had lower pain scores (by visual analog scale) at 4 weeks (P=.001), 12 weeks (P=.007), and 24 weeks (P=.002).
- The pregabalin group had 74% lower risk for PMPS at 12 weeks (11% vs 29%; relative risk, 0.26; P<.001>
- No difference between groups in rate of adverse events.
- Single-center study.