Effect of oral pregabalin on post operative analgesia in patients undergoing lumbar spine fusion surgeries under general anesthesia

Abstract

Pregabalin has been used successfully as a component of multimodal analgesia regimen in a variety of surgical procedures. However, side effects such as dizziness and somnolence have been reported especially with doses ≥300mg. We hypothesized that using a lower cumulative dose of oral pregabalin in a divided dosing regimen would lower the incidence of side effects while providing adequate postoperative analgesia in patients undergoing lumbar spine fusion surgery. Seventy adult patients of either sex of ASA 1-3, undergoing lumbar spine fusion surgery under general anesthesia were randomly divided into two equal groups. Group B received oral pregabalin 150mg one hour before induction and 75mg 2 hours after surgery. Group A received oral placebo at the corresponding time points. Pain was assessed using Visual Analogue Score (VAS) at extubation, 2, 4, 6, 12, 18 and 24 hours after surgery. In the first 24 hours after surgery, the mean VAS scores were significantly lower in Group B (P0.001) at all time points while tramadol consumption for rescue analgesia (P0.001) and postoperative nausea (P0.013) and vomiting (P0.011) were significantly higher in Group A. Preoperative anxiety and sedation scores and postoperative incidence of dizziness and somnolence were comparable between the two groups. Low dose oral pregabalin preoperatively and postoperatively using a divided dose regimen can be safely used to provide adequate postoperative analgesia with low incidence of side effects after lumbar spine fusion surgeries.