Gabapentinoids: Gabapentin and Pregabalin for Postoperative Pain Management

Imani, Farnad; Rahimzadeh, Poupak

doi:10.5812/aapm.7743

Cited by 65 publications

(44 citation statements)

References 22 publications

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“…PGB has a high affinity for the a-2-d (alpha-2-delta) subunit of voltage-gated calcium channels. Thus, calcium influx is reduced following PGB intake (8) and the calcium-dependent release of neurotransmitters involved in pain pathways (substance P, glutamate, and noradrenaline) decreases (8,11,12).…”

Section: Pregabalin General Pharmacologymentioning

confidence: 99%

Pregabalin Abuse in Combination With Other Drugs: Monitoring Among Methadone Patients

et al. 2020

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Introduction: In recent years, there has been an increase in the non-medical use of psychoactive prescription drugs including pregabalin (PGB). Studies have shown that multiple drug users and patients in methadone treatment programs administered PGB at high dosages in order to achieve euphoria, reduce withdrawal symptoms, or potentiate the effects of methadone. For these reasons, accurate toxicological monitoring is required for these high-risk individuals. Materials and Methods:The present study investigated whether PGB could be detected in the hair samples of 250 patients with a history of opiate dependency, and under toxicological surveillance assess their compliance with methadone maintenance therapy.Results: Opiates were found in 54/250 of all hair samples, while cannabis was present in 74/250 patients, cocaine was detected in 21/250 patients, and benzodiazepines without prescription were identified in 49/250 patients. As expected, methadone was present in all 250 patients (100%). PGB without prescription was found in the hair samples of 35/250 patients (14%). Of these, 91.43% were male, 48.57% were <30 y old, and 45.71% were between ages 30 and 50 y. There were no apparent associations among PGB use, daily methadone dosage, and duration of methadone maintenance therapy. Psychiatric comorbidities were present in 25.71% of the patients abusing PGB. Anxiety (55.56%) and depression (33.33%) were the most prevalent psychiatric disorders.Discussion: Most of the patients taking PGB (57.14%) used other drugs (especially opiates) concurrently. The utility of hair analysis is explained by easy and rapid sample collection and the ability of the hair to reflect long-term drug use and incorporate drug metabolites. The findings of this study suggested that PGB has significant potential for abuse by high-risk populations such as opioid users and patients with dual diagnosis. These risks are particularly high in cases of poly-drug use and drug intake that are not in compliance with prescription guidelines.

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Section: Pregabalin General Pharmacologymentioning

confidence: 99%

Pregabalin Abuse in Combination With Other Drugs: Monitoring Among Methadone Patients

et al. 2020

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“…1 Pain that lasts for a long time can become chronic. 3 There are different ways to reduce postoperative pain such as surgical blockage of pain transmitted neurons, non-opioid drugs or non-steroidal anti-inflammatory drugs (NSAIDs), opioid analgesic or patients controlled analgesia (PCA) and epidural analgesia. 2,[4][5][6] Surgical blockage effects on reducing pain is temporary and pain will come back after a while.…”

Section: Introductionmentioning

confidence: 99%

The Effects of Photobiomodulation Therapy on Post-Surgical Pain

2019

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Introduction: One of the major complains after surgery is pain. Recent advances in the prevention and reduction of postoperative pain have provided several modalities. One of them is the use of laser irradiation on the surgical area. Objectives: To evaluate the effects of low level laser therapy (LLLT) on pain and side effects after surgery. Methods: In this research, databases such as: PubMed, Science Direct, Google Scholar, Springer and Cochrane were used and the words of laser therapy, photobiomodulation, therapeutic laser, low level laser therapy, surgery and pain were searched. Articles, including systematic reviews, original articles, case series, and clinical intervention studies related to these words, were studied. The language of all articles was English and consists of papers from 2009 until 2017. Results: A total of 370 papers were studied and 10 articles that met inclusion criteria were selected for this review. Few of these articles were followed up. Surgery included a wide range of surgeries including mastectomy, breast augment post-fracture, episiotomy, tonsillectomy and hernia. The methodological quality score on the PEDro scale was between 5 and 11. 8 trials reported positive effects and 2 trials reported negative effects. In order to study clinical effect size of laser therapy after surgery, only 4 papers met entry criteria and the mean effect sizes were 0.13 to 2.77. Accordingly, the best treatment protocol included a red laser dose of 4 J/cm2 for the post-operative pain of tonsillectomy, which was irradiated through the infra mandibular angle on the tonsils. Conclusion: LLLT may be an appropriate modality for reducing pain after surgery, nevertheless the effect size of this modality is variable. Therefore, further research based on proper protocols for these patients and follow-up of therapeutic course should be designed and implemented.

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“…Another study reported that despite pain reduction in the gabapentin group, opioid consumption was not significantly different (25). It seems that preemptive gabapentinoids can have a positive effect on reducing postoperative pain and opioid consumption (26). …”

Section: Discussionmentioning

confidence: 99%

Multi-Modal Preemptive Analgesia With Pregabalin, Acetaminophen, Naproxen, and Dextromethorphan in Radical Neck Dissection Surgery: A Randomized Clinical Trial

et al. 2016

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BackgroundPreemptive analgesia may be considered as a method not only to alleviate postoperative pain but also to decrease analgesic consumption. Different regimens are suggested, but there is currently no standard.ObjectivesThe aim was to measure the efficacy of preemptive analgesia with pregabalin, acetaminophen, naproxen, and dextromethorphan in radical neck dissection surgery for reducing the intensity of pain and morphine consumption.Patients and MethodsThis study was conducted as a randomized double-blind clinical trial. Eighty adult patients (18 to 60 years of age) under the American society of anesthesiologists (ASA) physical status I and II undergoing elective radical neck dissection were enrolled. Patients were randomized into two groups of 40 with a simple randomization method. The case group received a combination of 15 mg/kg acetaminophen, 2.5 mg/kg pregabalin, 7 mg/kg naproxen, and 0.3 mg/kg dextromethorphan administered orally one hour prior to surgery. Postoperative pain was assessed with the universal pain assessment tool (UPAT) at 0, 2, 4, 6, 12, and 24 hours after surgery. Subjects received morphine based on postoperative pain control protocol. Total administered morphine doses were noted.ResultsPostoperative pain rates at 0, 2, 4, 6, 12, and 24 hours after surgery were significantly lower for the case group than the control group (P values = 0.014, 0.003, 0.00, 0.00, and 0.00, respectively). Total morphine doses for the preemptive analgesia group were 45% lower than those of the other group. Side effects were similar for both groups.ConclusionsA single preoperative oral dose of pregabalin, acetaminophen, dextromethorphan, and naproxen one hour before surgery is an effective method for reducing postoperative pain and morphine consumption in patients undergoing radical neck dissection.

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Gabapentinoids: Gabapentin and Pregabalin for Postoperative Pain Management

Cited by 65 publications

References 22 publications

Pregabalin Abuse in Combination With Other Drugs: Monitoring Among Methadone Patients

Pregabalin Abuse in Combination With Other Drugs: Monitoring Among Methadone Patients

The Effects of Photobiomodulation Therapy on Post-Surgical Pain

Multi-Modal Preemptive Analgesia With Pregabalin, Acetaminophen, Naproxen, and Dextromethorphan in Radical Neck Dissection Surgery: A Randomized Clinical Trial

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