Evaluation of the Efficacy of Prolonged Pregabalin Administration Before and After Surgery in Patients Undergoing Arthroscopic Anterior Cruciate Ligament Repair

Abstract

Context and Objective: Reconstruction of the knee ligament causes postoperative pain and delayed rehabilitation. Objective: The primary objective of this study was to evaluate the effect of a prolonged preoperative and postoperative pregabalin use for arthroscopic anterior cruciate ligament repair. Materials and Methods: Group 1 (N=25) patients received pregabalin 75 mg/d, and group 2 (N=25) received placebo, 7 days before and 7 days after surgery. Spinal anesthesia was performed using 0.5% hyperbaric bupivacaine (15 mg). The following were evaluated: pain intensity immediately after the surgery, and 12 hours, 24 hours, 1 week, 2 weeks, 1 month, and 2 months after the surgery using a Numerical Rating Scale; dose of postoperative supplementary analgesic for 2 months; time to first analgesic requirement; and side effects during 2 months. For supplementation, the participants received 1 g dipyrone; if there was no pain control, 100 mg ketoprofen was administered; if there was no effect, 100 mg tramadol was administered; and if there was no pain control, 5 mg intravenous morphine was administered until pain control. Results: There was no difference between the groups with regard to pain intensity (P=0.077). In the pregabalin group, morphine consumption was lower at 12 hours (P=0.039) and 24 hours (P=0.044) after surgery, and the consumption of tramadol and ketoprofen was lower 24 hours after surgery. There was no significant difference in the incidence of nausea and vomiting. Dizziness was higher in the pregabalin group (group 1=12 patients; group 2=3 patients; P=0.005). Discussion: A prolonged preoperative and postoperative pregabalin prescription for anterior cruciate ligament repair decreased the need for supplementary analgesics during the first 24 postoperative hours but increased dizziness.

The effect of pregabalin on postoperative pain after anterior cruciate ligament reconstruction: A systematic review of randomized clinical trials

“…In Akelma et al 17 study, mean tramadol consumption in the pregabalin group was 178.75 mg and 318.61 mg in the control group ( p < 0.05). Moreover, in Tobias et al 21 study, median tramadol consumption 24 hours after surgery was 200 mg and 400 mg in the pregabalin and control group ( p = 0.021), respectively.…”

“…Akelma et al and Tobias et al reported significantly lower postoperative opioid consumption in the pregabalin group in comparison with the control group. 17,21 However, Cho et al and Nimmaanrat et al did not find a significant difference. 19,20 Finally, Fortis-Olmedo et al 18 found significantly lower opioid consumption in the 150 mg pregabalin group in comparison with the control and 75 mg pregabalin groups.…”

Liposomal Bupivacaine Decreases Post-Operative Opioid Use after Anterior Cruciate Ligament Reconstruction: A Review of Level I Evidence

“…26 A final study determined that prolonged administration of pregabalin 7 days before and after ACL reconstruction decreased the need for supplemental analgesics. 27 Thus, pregabalin may also represent a potential addition to future multimodal pain strategies in ACLRs.…”

Oral pregabalin is effective as preemptive analgesia in abdominal hysterectomy—A randomized controlled trial

“…Clinical uses of pregabalin are already well established in the treatment of neuropathic pain, post‐herpetic neuralgia, and epilepsy 6–8 . Previous studies have shown a reduction in postoperative pain and lower consumption of opioids using these drugs, but further studies are still needed to clarify their indications in this context 2,9–11 …”

“…[6][7][8] Previous studies have shown a reduction in postoperative pain and lower consumption of opioids using these drugs, but further studies are still needed to clarify their indications in this context. 2,[9][10][11] This study assessed a better recovery of patients in the postoperative period by oral administration of 300 mg of pregabalin, 2 h before the surgical procedure of abdominal hysterectomy, aiming to reduce pain-as measured by the visual analogue scale (VAS) and the McGill's pain questionnaire-and as a secondary outcome, to reduce the consumption of opioids as an analgesic rescue drug. The hypothesis is that patients who received pregabalin in the preoperative period would present lower pain rates 24 h postoperatively compared to the placebo group.…”