Analgesic efficacy of preemptive pregabalin administration in arthroscopic shoulder surgery: a randomized controlled trial

Abstract

PURPOSE: The purpose of the current study was to evaluate the effects of pregabalin administration as an adjunct to fentanyl-based intravenous patient-controlled analgesia on opioid consumption and postoperative pain following arthroscopic shoulder surgery. METHODS: In this randomized controlled trial, 60 adult patients undergoing arthroscopic shoulder surgery were randomly assigned to receive either pregabalin 150 mg (Pregabalin group, n = 30) or placebo (Control group, n = 30) one hour before anesthetic induction. The primary outcome was the cumulative amount of fentanyl consumption during 48 hr postoperatively. Secondary outcomes were pain intensity, the number of rescue analgesics administered, and adverse effects related to the analgesic regimen, which were serially assessed during 48 hr postoperatively. RESULTS: The cumulative fentanyl consumption during 48 hr postoperatively was significantly lower in the Pregabalin group than in the Control group ([1,126.0 (283.6) mug vs 1,641.4 (320.3) mug, respectively; mean difference, 515.4 mug; 95% confidence interval [CI], 359.0 to 671.8; P = < 0.001). Numeric rating scores for pain (0 to 10) were significantly lower in the Pregabalin group at six hours (mean difference, 2.9; 95% CI, 1.8 to 4.0), 24 hr (mean difference, 2.9; 95% CI, 1.9 to 3.8), and 48 hr (mean difference, 1.5; 95% CI, 0.6 to 2.3). The incidence of adverse effects related to the analgesic regimens, including nausea, sedation, and dizziness, were similar between the two groups. CONCLUSION: A preoperative dose of pregabalin 150 mg administered before arthroscopic shoulder surgery resulted in significant analgesic efficacy for 48 hr in terms of opioid-sparing effect and improved pain intensity scores without influencing complications. This trial was registered at: http://cris.nih.go.kr , number CT0000578.