A Randomized, Double-Blind, Placebo-Controlled Trial of Pre-emptive Pregabalin for Postoperative Pain after Laparoscopic Hysterectomy in Benign Gynecologic diseases
Sanguanwongthong K, MD1, Imruetaicharoenchok A, MD1, Phaloprakarn C, MD1, Vitayaburananont P, MD2
Affiliation : 1 Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand 2 Department of Anesthesiology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
Objective : To investigate the efficacy of pre-operative pregabalin administration to relieve postoperative pain among patients
undergoing laparoscopic hysterectomy.
Materials and Methods : A randomized controlled trial study was conducted on 30 women with benign gynecologic diseases who
underwent laparoscopic hysterectomy. The patients were randomly allocated into two groups: pregabalin group (n = 15) received
150-mg oral pregabalin capsule and placebo group (n = 15) received placebo of identical features. Either pregabalin or placebo was
administered orally to each patient 2 hours before the commencement of laparoscopic hysterectomy. After the operation, all
patients received patient-controlled analgesia with intravenous fentanyl. The outcome measures included postoperative pain
assessed by visual analogue score (VAS) at 6, 12, and 24 hours after drug administration, fentanyl consumption within 24 hours
after surgery, and side effects of pregabalin. The analysis was by per protocol.
Results : Among 30 patients included, 27 patients were enrolled for analysis. There are 3 patients were excluded from the present
study because 2 patients were converted operation to laparotomy and 1 patient did the operation more than 4 hours. The visual
analogue scale (VAS) pain score at 6 and 12 hours was significantly decreased in the pregabalin group compared to the placebo group
(p = 0.001 and 0.001 respectively). The VAS scores at 24 hours of both groups were not significantly different (p = 0.905). The
fentanyl consumptions within 24 hours were 133.92+77.94 mcg in pregabalin vs. 337.63+178.47 mcg in placebo groups (p =
0.001). Side effects of pregabalin including nausea, vomiting, and sedation were comparable between the two groups.
Conclusion : The pre-emptive administration of 150-mg pregabalin significantly reduced postoperative pain for at least 12 hours
after administration, without a significant increase in adverse effects, among patients undergoing laparoscopic hysterectomy.
Keywords : Pregabalin, Pre-emptive, Postoperative pain, Laparoscopic hysterectomy
