Department of Anesthesiology and Perioperative Medicine, Kingston General Hospital, Queen's University, 76 Stuart Street, Kingston, ON, K7L 2V7, Canada.
J Anesth. 2012 Dec;26(6):829-35. doi: 10.1007/s00540-012-1447-x. Epub 2012 Jul 14.
Multimodal analgesia increases the chance of successful discharge and pain control after surgery, and pregabalin is being promoted as an effective analgesic, based on placebo-controlled studies. We investigated whether adding pregabalin improved pain control and reduced opioid requests when it was added to a multimodal analgesic regimen for cosmetic surgery.
One hundred and ten women who underwent same-day cosmetic surgery were randomized to receive oral pregabalin, 75 mg q12 h for five consecutive days starting the night before surgery, or identical placebos. Participants, outcomes assessors, and the statistician were blinded. The primary outcome was postoperative numerical movement-evoked pain scores at 2, 24, 48, 72, and 96 h after surgery. The secondary outcomes included pain scores at rest; incidence of moderate to severe pain; and analgesic and antiemetic requirements; as well as the incidence of nausea, vomiting, and somnolence.
Based on 99 patients who completed the study, we found no difference between the groups in the primary outcome; 72 h after surgery, movement-evoked median pain scores were <4/10 in both groups. We found no differences in opioid requirements (p = 0.95) or anti-inflammatory requirements (p = 0.45), and no difference in opioid-related adverse events.
Perioperative pregabalin 75 mg twice a day does not increase benefit when it is added to an already multimodal analgesic regimen for patients undergoing cosmetic surgery. Several factors could explain our findings, including the possibility of publication bias in the current literature.
多模式镇痛增加了手术后成功出院和疼痛控制的机会，而普瑞巴林基于安慰剂对照研究被推广为一种有效的镇痛剂。我们研究了在美容手术的多模式镇痛方案中添加普瑞巴林是否可以改善疼痛控制并减少阿片类药物的需求。
110 名接受日间美容手术的女性随机分为两组，分别接受口服普瑞巴林（手术前一天晚上开始，每天两次，每次 75mg，连续 5 天）或安慰剂。参与者、结果评估者和统计学家均不知情。主要结局是手术后 2、24、48、72 和 96 小时的数字运动诱发疼痛评分。次要结局包括静息时的疼痛评分、中度至重度疼痛的发生率、以及镇痛和止吐药的需求；以及恶心、呕吐和嗜睡的发生率。
基于 99 名完成研究的患者，我们发现两组在主要结局上没有差异；手术后 72 小时，两组的运动诱发疼痛评分中位数均<4/10。我们发现两组在阿片类药物需求（p=0.95）或抗炎药物需求（p=0.45）方面没有差异，也没有发现阿片类药物相关不良事件的差异。
在接受美容手术的患者已经接受多模式镇痛方案的基础上，围手术期每天两次给予 75mg 普瑞巴林并不能增加获益。我们的研究结果可能有几个因素解释，包括当前文献中存在发表偏倚的可能性。
