Influence of pregabalin on post-operative pain after laparoscopic cholecystectomy: A meta-analysis of randomised controlled trials

Abstract

Pregabalin may have some potential in reducing post-operative pain after laparoscopic cholecystectomy. However, the results remain controversial. We conduct a systematic review and meta-analysis to explore the influence of pregabalin on post-operative pain after laparoscopic cholecystectomy. Materials and Methods: PubMed, Embase, Web of science, EBSCO and Cochrane Library databases have been systematically searched. Randomised controlled trials (RCTs) assessing the effect of pregabalin versus placebo on post-operative pain after laparoscopic cholecystectomy are included. The primary outcomes are pain scores at 8-12 h and 20-24 h. Secondary outcomes include sedation score, intraoperative fentanyl requirement, post-operative analgesic requirement, operative duration, post-operative nausea and vomiting, as well as respiratory depression. This meta-analysis is performed using the random-effect model. Results: Eight RCTs involving 528 patients were included in the meta-analysis. Overall, compared with control intervention after laparoscopic cholecystectomy, pregabalin treatment is found to significantly reduce pain scores at 20-24 h (Standard Mean difference [Std. MD] = -0.46; 95% confidence interval [CI] = -0.82 - 0.10), and post-operative analgesic requirement (Std. MD = -2.64; 95% CI = -3.94 - 1.33), but cannot substantially decrease pain scores at 8-12 h (Std. MD = -0.71; 95% CI = -1.70-0.27). In addition, pregabalin results in improved sedation score (Std. MD = 0.92; 95% CI = 0.55-1.29), but has no remarkable influence on intraoperative fentanyl requirement (Std. MD = 0.04; 95% CI = -0.30-0.39), operative duration (Std. MD = 0.34; 95% CI = -0.10-0.77), post-operative nausea and vomiting (Std. MD = 0.79; 95% CI = 0.59-1.11) as well as respiratory depression (Std. MD = 0.71; 95% CI = 0.17-3.02). Conclusions: Compared to control intervention after laparoscopic cholecystectomy, pregabalin treatment can significantly decrease pain scores at 20-24 h and post-operative analgesic requirement, with no increase in adverse events.