title: Pregabalin and dexamethasone improves post-operative pain treatment after tonsillectomy.
abstract: BACKGROUND
  Post-tonsillectomy pain can be severe. We investigated the analgesic effect from combinations of paracetamol, pregabalin and dexamethasone in adults undergoing tonsillectomy.
  
  
  METHODS
  In this randomized double-blind study, 131 patients were assigned to either group A (paracetamol+placebo), group B (paracetamol+pregabalin+placebo) or group C (paracetamol+pregabalin+dexamethasone). Pre-operatively, patients received either paracetamol 1000 mg, pregabalin 300 mg, dexamethasone 8 mg or placebo according to their allocation. Post-operative pain treatment included paracetamol 1000 mg 4× and ketobemidone 2.5 mg p.n. Ketobemidone consumption, pain scores [visual analogue scale (VAS)], nausea, sedation, dizziness, number of vomits and consumption of ondansetron were recorded 2, 4 and 24 h after the operation. P<0.05 was considered statistically significant.
  
  
  RESULTS
  The mean 24-h VAS-pain score at rest was reduced in group C (P<0.003) vs. group A. The mean 24-h VAS-pain scores during swallowing were reduced in group B (P=0.009) and group C (P<0.003) vs. group A. Consumption of ketobemidone (1-4 h post-operatively) was lower in group B (P=0.003) and group C (P=0.003) vs. group A. The mean 24-h dizziness score was higher in group B (P<0.003) and C (P=0.003) vs. group A. Other parameters including re-operation for post-tonsillectomy bleeding were not different between groups.
  
  
  CONCLUSIONS
  Pregabalin and pregabalin+dexamethasone reduced post-operative pain scores and consumption of ketobemidone following tonsillectomy. Dizziness was increased with pregabalin.
authors.affiliation: Section of Acute Pain Management and Palliative Medicine 4114, Copenhagen University Hospital, Department of Anaesthesia 4231, Centre of Head and Orthopaedics, Copenhagen University, Rigshospitalet, Copenhagen, Denmark. olemat@dadlnet.dk
authors.forename: O
authors.initials: O
authors.lastname: Mathiesen
authors.forename: D G
authors.initials: DG
authors.lastname: Jørgensen
authors.forename: K L
authors.initials: KL
authors.lastname: Hilsted
authors.forename: W
authors.initials: W
authors.lastname: Trolle
authors.forename: P
authors.initials: P
authors.lastname: Stjernholm
authors.forename: H
authors.initials: H
authors.lastname: Christiansen
authors.forename: N C
authors.initials: NC
authors.lastname: Hjortsø
authors.forename: J B
authors.initials: JB
authors.lastname: Dahl
mesh_terms: D000082:Acetaminophen / Q000008:administration & dosage; D000328:Adult; D000700:Analgesics / Q000008:administration & dosage*; D003907:Dexamethasone / Q000008:administration & dosage*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D000069583:Pregabalin; D011446:Prospective Studies; D014068:Tonsillectomy; D005680:gamma-Aminobutyric Acid / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*
chemical_list: D000700:Analgesics; D000082:Acetaminophen; D000069583:Pregabalin; D005680:gamma-Aminobutyric Acid; D003907:Dexamethasone