Preventive analgesia with pregabalin in neuropathic pain from "failed back surgery syndrome": Assessment of sleep quality and disability

Abstract

Objective. Pregabalin group (PGB) is an antiepileptic used to treat neuropathic pain. We evaluated analgesic efficacy and safety for postoperative/ chronic pain, disability, and sleep quality in patients who underwent spine surgery administered with PGB, or not, during the presurgical and postsurgical periods. Design. Retrospective cohort study of 60 patients (two groups with 30 patients) with full information on 50 (29 with PGB and 21 without PGB). Ten patients were dismissed as information was lacking. The PGB group (P) (29 patients) received 75 mg/12 hours before surgery, 150 mg 10 hours after surgery, and 150 mg/12 hours 3 days after surgery. The control group (C; 21 patients) took no PGB. Methods. Neuropathic pain was assessed before surgery, and 2 and 6 months later using visual analog scales (VAS), DN4, disability (Oswestry), and sleep quality. No serious adverse events occurred with PGB. Results. The median VAS pain score at rest was lower in the PGB group at 2 months postsurgery (1 vs 2, P50.032), as was the median DN4 score (0 vs 3, P50.032) and the median Oswestry disability index (ODI: 12 vs 18, P50.001). At 6 months postsurgery, pain scores were also lower in the PGB group for VAS (0 vs 4, P50.001), DN4 score (0 vs 4, P50.001) and the ODI (10 vs 24, P50.001). Improvement in the functionality and sleep quality of the PGB group was noteworthy (P50.018). Conclusions. PGB has analgesic/antihyperalgesic effects on postoperative neuropathic pain after surgery for lumbar disc hernia. Our findings show that this benefit increases with time. VC 2015 American Academy of Pain Medicine. All rights reserved.