Perioperative pregabalin improves pain and functional outcomes 3 months after lumbar discectomy.
BACKGROUND
Patient outcome after lumbar discectomy for radicular low back pain is variable and the benefit is inconsistent. Many patients continue to experience pain 3 months after surgery. Pregabalin, a membrane stabilizer, may decrease perioperative central sensitization and subsequent persistent pain.


METHODS
Forty patients undergoing lumbar discectomy were randomly allocated to receive either pregabalin (300 mg at 90 minutes preoperatively and 150 mg at 12 and 24 hours postoperatively) or placebo at corresponding times in a double-blinded manner. Our primary outcome was the change in the present pain intensity (PPI) (visual analog scale [VAS], 0-100 mm [PPI-VAS, McGill Pain Questionnaire]) from preoperatively to 3 months postoperatively.


RESULTS
The decrease in PPI-VAS score at 3 months was greater in patients who received pregabalin (37.6 +/- 19.6 mm) (mean +/- sd) than those who received placebo (25.3 +/- 21.9 mm) (P = 0.08). The Roland Morris disability score at 3 months was less in patients who received pregabalin (2.7 +/- 2.4) than in those who received placebo (5.6 +/- 4.8) (P = 0.032). Pregabalin administration was associated with greater pain tolerance thresholds in both lower limbs compared with placebo at 24 hours postoperatively.


CONCLUSIONS
Perioperative pregabalin administration is associated with less pain intensity and improved functional outcomes 3 months after lumbar discectomy.
Burke
Siun M
SM
Department of Anaesthesia and Intensive Care Medicine, Cork University Hospital, Wilton, Cork, Ireland. siunburke@hotmail.com
Shorten
George D
GD
D000293:Adolescent; D000328:Adult; D000700:Analgesics / Q000009:adverse effects / Q000627:therapeutic use*; D000758:Anesthesia; D004247:DNA / Q000235:genetics; D017586:Diskectomy; D004311:Double-Blind Method; D004558:Electric Stimulation; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000187:drug effects; D017288:Pain Threshold / Q000187:drug effects; D010149:Postoperative Pain / Q000188:drug therapy*; D000069583:Pregabalin; D017450:Receptors, Opioid, mu / Q000235:genetics; D020133:Reverse Transcriptase Polymerase Chain Reaction; D016896:Treatment Outcome; D055815:Young Adult; D005680:gamma-Aminobutyric Acid / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use
D000700:Analgesics; C485764:OPRM1 protein, human; D017450:Receptors, Opioid, mu; D000069583:Pregabalin; D005680:gamma-Aminobutyric Acid; D004247:DNA