Pregabalin Has Opioid-Sparing Effects Following Augmentation Mammaplasty

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There has been a recent, growing concern regarding narcotic use in surgical patients. This issue, coupled with an ongoing desire to lessen postoperative discomfort, has prompted the search for alternative analgesic regimens. The purpose of this study was to determine whether the addition of pregabalin, an anticonvulsant indicated for the management of neuropathic pain, to an analgesic regimen reduced narcotic use and reported pain following augmentation mammaplasty. Eighty patients underwent submuscular augmentation mammaplasty with smooth shell saline mammary prostheses in an outpatient surgical facility. The patients were randomized into two groups. Group A (n = 40) used 5-mg hydrocodone tablets as needed to manage postoperative pain. Group B (n = 40) used pregabalin, 75 mg, twice daily in addition to 5-mg hydrocodone tablets as needed for postoperative pain management. Narcotic use was recorded and pain assessed daily using the Rogers Pain Scale from 1 (mild) to 10 (severe). Patients were surveyed for nausea and quality of pain. Group A used 115 +/- 32 mg hydrocodone during the immediate 7 day postoperative period and reported an average pain scale score of 5.3. Likewise, group B used 33 +/- 27 mg hydrocodone as well as the prescribed pregabalin dosage and reported an average pain scale score of 3.4. Patients in group B reported less nausea. These differences were statistically significant (P < .05). Patient age, implant size, and postoperative complications were similar between the two groups. Perioperative pregabalin administration in patients undergoing augmentation mammaplasty reduced postoperative narcotic use by 70%. There was also significantly less reported pain and a 46% reduction in nausea in the pregabalin-treated group. Pregabalin has few side effects, no drug interactions, and should be considered safe in an analgesic regimen.