The role of preoperative oral pregabalin on acute post?operative pain after orthopedic lower limb surgery

Abstract

Introduction: Postoperative pain after orthopedic surgery has remained a challenging problem, which prolongs hospital stay and early rehabilitation. Pregabalin comes under class of gabapentinoids that have been used in postoperative pain in arthroplasty and spine surgeries but studies regarding its role as preemptive analgesia in orthopedic limb surgeries are very few. Aim: To study the efficacy and safety of pregabalin as preemptive medication for acute postoperative pain management in patients undergoing orthopedic lower limb fracture surgeries. Materials and Methods: A randomized double blinded prospective study was undertaken. Sixty patients were enrolled with age between 18–70 years and were divided into 2 groups. Group A ­ received 150mg of oral pregabalin capsule, Group B – received matched colour empty capsules. Standard spinal anaesthesia was given. Breakthrough analgesia was given with Inj. Diclofenac 1.5 mg/kg i/m. Assessment of pain was done with visual analog scale (VAS). Results: There was marked reduction in postoperative VAS score in group A and the amount of breakthrough analgesia needed in the 24-hour postoperative period was also much lower in the Group A as compared to the Group B. Conclusion: 150mg of oral pregabalin as preemptive medication offers satisfactory postoperative analgesia in orthopaedic lower limb fracture surgeries with very few undesirable side effects. Keywords: Postoperative pain, Pregabalin, Gabapentinoids, Preemptive analgesia, Diclofenac, Visual analog scale.