Analgesic effects of a single preoperative dose of pregabalin after laparoscopic sleeve gastrectomy.
BACKGROUND
The treatment of pain in obese patients is always a challenge. These patients have low pain thresholds, and the use of opioids can be especially harmful. Intraoperative nervous fiber section and the high temperatures of electrical scalpels probably contribute to the generation of postoperative neuropathic pain. We hypothesized that an antineuropathic pain drug like pregabalin could be helpful to optimize postoperative analgesia by reducing the requirement for opioids and their associated side effects.


METHODS
Eighty adults undergoing laparoscopic sleeve gastrectomy were randomly assigned to orally receive either placebo capsules (control) or pregabalin (150 mg) 2 h before surgery. Postoperative morphine consumption during the first 24 postoperative hours was registered. Visual analog pain scores (VAS) were assessed at 1, 2, 4, 6, 8, 12, 16, and 24 h after surgery. Both the incidence of adverse reactions and patient satisfaction were also assessed.


RESULTS
Over a 24-h period, the morphine consumption in the pregabalin group was 11.51 ± 7.93 mg, whereas in the control group, it was 23.07 ± 9.57 mg (p < 0.0001). VAS scores were significantly lower in the pregabalin group. Postoperative nausea and vomiting and the consumption of antiemetics were reduced in the pregabalin group.


CONCLUSIONS
A single preoperative oral dose of 150 mg pregabalin is useful for reducing morphine consumption after a sleeve gastrectomy, and it guarantees effective and safe analgesia with a low incidence of adverse effects.
Cabrera Schulmeyer
Maria Carolina
MC
Air Force Hospital of Santiago de Chile and University of Valparaiso, Valparaiso, Chile. carol218@vtr.net
de la Maza
Jaime
J
Ovalle
Cristian
C
Farias
Carlos
C
Vives
Isabel
I
D000328:Adult; D000368:Aged; D000698:Analgesia / Q000379:methods; D000700:Analgesics / Q000008:administration & dosage / Q000627:therapeutic use*; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000932:Antiemetics / Q000627:therapeutic use; D004311:Double-Blind Method; D005260:Female; D005743:Gastrectomy; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000188:drug therapy; D009765:Obesity / Q000601:surgery; D010149:Postoperative Pain / Q000188:drug therapy* / Q000517:prevention & control; D020250:Postoperative Nausea and Vomiting / Q000188:drug therapy / Q000517:prevention & control; D000069583:Pregabalin; D011300:Preoperative Care / Q000379:methods*; D055815:Young Adult; D005680:gamma-Aminobutyric Acid / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use
D000700:Analgesics; D000701:Analgesics, Opioid; D000932:Antiemetics; D000069583:Pregabalin; D005680:gamma-Aminobutyric Acid