Combination of Pregabalin and Dexamethasone for Postoperative Pain and Functional Outcome in Patients Undergoing Lumbar Spinal Surgery: A Randomized Placebo-controlled Trial

Abstract

OBJECTIVES: In this randomized-controlled study, we investigated the effects of combined administration of pregabalin and dexamethasone on postoperative pain and analgesic requirements, and functional outcome in patients who underwent lumbar spinal surgery. METHODS: One hundred eight patients were randomized to group C (placebo+placebo), group P (pregabalin + placebo), or group PD (pregabalin+dexamethasone). According to their allocated group, patients received placebo or pregabalin 150 mg every 12 hours starting 1 hour before anesthetic induction for a total of 8 doses. Dexamethasone 16 mg or normal saline was injected before the induction of anesthesia. The pain intensity, analgesic requirements, and side effects were assessed in the postoperative period: postanesthesia care unit, 12, 24, 48, and 72 hours. Pain intensity and daily activity performance were also assessed 1, 3, and 6 months after surgery. RESULTS: Compared with group C, the pain scores were lower in group PD at 24 hours after surgery (P = 0.011). The frequency of additional rescue analgesic administration was significantly lower in group PD until 48 hours after surgery (P < 0.05) and in group P at 24 to 48 hours (P = 0.005) relative to group C. Back pain intensity at work was lower (P = 0.048) and daily activity performance was better (P = 0.006) in group PD compared with group C at 1 month after surgery. CONCLUSIONS: Combined administration of pregabalin and dexamethasone conferred analgesic benefits superior to those of pregabalin alone. This regimen also helped facilitate return to normal daily activity after surgery.