Journal of Anesthesia and Surgery
Perioperative Pregabalin for Postoperative Pain Relief after Thoracotomy
- 1Second Department of Anaesthesiology, University of Athens, Attikon Hospital, Athens, Greece
- 2Department of Anaesthesiology, Sismanoglion Hospital, Athens, Greece
- 3Department of Thoracic Surgery, Sismanoglion Hospital, Athens, Greece
Tatiana Sidiropoulou, Second Department of Anaesthesiology, University of Athens, Attikon Hospital, Rimini 1, Haidari, 12462, Athens, Greece, E-mail: email@example.com
Sidiropoulou, T., et al. Perioperative Pregabalin for Postoperative Pain Relief after Thoracotomy. (2016) J Anesth Surg 3(1): 106- 111.
© 2016 Sidiropoulou, T. This is an Open access article distributed under the terms of Creative Commons Attribution 4.0 International License.
KeywordsPain postoperative; Analgesics pregabalin; Analgesics morphine; Thoracotomy; Anesthetics local
Background: Pregabalin is effective both at controlling postoperative pain and preventing chronic neuropathic pain. Local anaesthetic infiltration is a simple and inexpensive method to provide postoperative analgesia. In this study we tested the hypothesis that pregabalin administered perioperatively combined with continuous wound infusion will aid better the post-thoracotomy pain management compared to pregabalin monotherapy.
Methods: Forty five patients received either placebo (PLCB), pregabalin (PRG) or pregabalin and continuous wound infusion (PRG CWI) of local anaesthetics. Postoperative data collection included opioid consumption, VAS scores at rest and during cough. At 1 and 3 months from surgery patients were assessed with the DN4 questionnaire for neuropathic pain.
Results: VAS scores were significantly lower in the PRG CWI group (p < 0.05) at rest while during cough the placebo group had higher scores than both treatment groups (p < 0.001 or p < 0.05). Morphine consumption measured at 48 hr PO revealed a significant difference in total morphine; PLCB: 49 ± 11mg, PRG: 33 ± 10mg and PRG CWI: 28 ± 11mg (p < 0.001 between placebo and the other two groups). The incidence of neuropathic pain was more frequent in the placebo group (1-month: PLCB: 10 pt, PRG: 0 pt and PRG CWI: 0 pt (p < 0.001), 3 months: PLCB: 10 pts, PRG: 0 pt and PRG CWI: 0 pt (p < 0.001)).
Conclusions: Perioperative administration of pregabalin significantly reduces pain scores, opioid consumption and incidence of neuropathic pain in post-thoracotomy patients. The addition of continuous wound infiltration of local anaesthetics although improved immediate postoperative analgesia at rest did not affect differently the development of neuropathic pain.