Evaluation of a single preoperative oral pregabalin for attenuating postoperative pain after laminectomy with posterolateral fusion

Abstract

Background: Optimal postoperative analgesia with minimal side effects is essential for early mobility and recovery in patients undergoing laminectomy. A combination of opioid and non - opioid analgesic drugs may improve the quality of postoperative analgesia, reduce opioid requirement and their associated side effects after surgery.

Objective: To evaluate the efficacy of a single preoperative oral pregabalin for attenuating postoperative pain and morphine consumption after laminectomy with posterolateral fusion.

Methods: Prospective randomized controlled trial was conducted. Sixty patients undergoing elective decompressive lumbar laminectomy with posterolateral fusion were randomly assigned to two groups of 30 patients each. The control group received oral placebo, and the study group received 150 mg of oral pregabalin 2 h before surgery. Postoperative analgesic was 2 mg dose of morphine i.v. every 2 h on request in 24 h. The visual analogue scale (VAS) scores for pain, sedation scores, total dose of morphine and side effects were recorded for 24 h after surgery.

Results: Postoperative VAS pain scores in the PACU at 4, 8, 12 after operation were significantly lower in pregabalin group compared with the placebo group. Twenty – four – hour morphine consumption was significantly reduced in the pregabalin group compared with the placebo group (5.9 + 1.4 mg versus 11.9 + 3.4 mg). Adverse effects were similar in both groups.

Conclusion: A single preoperative 150 mg of oral pregabalin is an effective method for reducing postoperative pain and morphine consumption in patients undergoing decompressive lumbar laminectomy with posterolateral fusion.