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Effective dose of peri-operative oral pregabalin as an adjunct to multimodal analgesic regimen in lumbar spinal fusion surgery.

 Jong Chan Kim  ;  Yong Seon Choi  ;  Keung Nyun Kim  ;  Jae Kwang Shim  ;  Ji Yeon Lee  ;  Young Lan Kwak 
 SPINE, Vol.36(6) : 428-433, 2011 
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Adult ; Analgesics/administration & dosage ; Analgesics/therapeutic use* ; Dose-Response Relationship, Drug ; Double-Blind Method ; Drug Administration Schedule ; Female ; Humans ; Lumbar Vertebrae/surgery* ; Male ; Middle Aged ; Pain, Postoperative/etiology ; Pain, Postoperative/prevention & control ; Perioperative Care ; Pregabalin ; Prospective Studies ; Spinal Fusion/adverse effects ; Spinal Fusion/methods* ; Time Factors ; Treatment Outcome ; gamma-Aminobutyric Acid/administration & dosage ; gamma-Aminobutyric Acid/analogs & derivatives* ; gamma-Aminobutyric Acid/therapeutic use
pregabalin, perioperative pain, posterior lumbar spinal ; fusion
STUDY DESIGN: A prospective, randomized, controlled, and double-blind trial. OBJECTIVE: To evaluate the effects of 2 different doses of perioperative pregabalin administration, twice on the day of surgery, on acute postoperative pain after spinal surgery. SUMMARY OF BACKGROUND DATA: Besides its well-established role on neuropathic pain, pregabalin seems to be a promising adjunct to multimodal analgesic regimen following surgery. No comprehensive data exist regarding the optimal dosage of pregabalin on reducing postoperative pain and opioid consumption in spinal surgery. METHODS: Patients were randomly assigned to 1 of 3 groups. The placebo group (n = 28) received placebo capsules 1 hour before the anesthetic induction and 12 hours after surgery. The pregabalin groups received pregabalin 75 mg (P75 group, n = 28) or 150 mg (P150 group, n = 28), respectively at the same points. Assessed variables were total amount of administered fentanyl-based intravenous patient-controlled analgesia, pain intensity, and the frequency of rescue analgesic administered during the first 48 hours after surgery, subdivided into the following 4 periods: on arrival of patient to the postanesthesia care unit, 1 to 6 hours, 6 to 24 hours, and 24 to 48 hours. RESULTS.: The amount of patient-controlled analgesia volume infused until 24 hours (P 5 0.025) and 48 hours (P 5 0.028) after surgery was significantly less in the P150 group compared with the control group. The frequency of additional anodynes administered until 6 hours (P 5 0.049) and 24 hours (P 5 0.045) after surgery was significantly less in the P150 group compared with the control group. CONCLUSION: Perioperative administration of pregabalin 150 mg before and 12 hours after surgery, but not 75 mg, significantly reduced opioid consumption and the use of additional pain rescue for 48 hours after surgery without significant side effects in patients undergoing spinal fusion surgery.
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1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Kwak, Young Lan(곽영란) ORCID logo https://orcid.org/0000-0002-2984-9927
Kim, Keung Nyun(김긍년)
Kim, Jong Chan(김종찬)
Shim, Jae Kwang(심재광) ORCID logo https://orcid.org/0000-0001-9093-9692
Choi, Yong Seon(최용선) ORCID logo https://orcid.org/0000-0002-5348-864X
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