title: Pregabalin has an opioid-sparing effect in elderly patients after cardiac surgery: a randomized placebo-controlled trial.
abstract: BACKGROUND
  In this prospective, randomized, double-blind, placebo-controlled study, we investigated the effect of pregabalin on oxycodone consumption, postoperative confusion, and pain in elderly cardiac surgery patients.
  
  
  METHODS
  Seventy patients, aged ≥75 yr, were randomized to receive either 150 mg of pregabalin before operation and 75 mg of pregabalin twice daily for 5 postoperative days or placebo. Pain intensity was measured with the Verbal Rating Scale (VRS). When pain intensity was ≥2 on the VRS, patients received oxycodone either i.v. (0.05 mg kg(-1)) or orally (0.10-0.15 mg kg(-1)). Postoperative confusion was measured with the Confusion Assessment Method for the intensive care unit (CAM-ICU). Postoperative pain was assessed by a telephone interview 1 and 3 months after operation.
  
  
  RESULTS
  Cumulative consumption of parenteral oxycodone during 16 h after extubation was reduced by 44% and total oxycodone consumption from extubation to the end of the fifth postoperative day was reduced by 48% in the pregabalin group. Time to extubation was 138 min shorter and CAM-ICU scores were significantly lower on the first postoperative day in the placebo group, although there was no significant difference with respect to the Mini-Mental State Examination or the Richmond Agitation Sedation Score. The incidence of pain during movement was significantly lower in the pregabalin group at 3 months postoperative.
  
  
  CONCLUSIONS
  The administration of pregabalin reduced postoperative opioid consumption after cardiac surgery reduced the incidence of confusion on the first postoperative day and increased time to extubation when compared with placebo. Three months after operation, patients in the pregabalin group experienced less pain during movement.
authors.affiliation: Department of Anaesthesiology and Intensive Care Medicine, Helsinki University Hospital, PO BOX 340, FIN-00029 HUS Helsinki, Finland. anne.pesonen@hus.fi
authors.forename: A
authors.initials: A
authors.lastname: Pesonen
authors.forename: R
authors.initials: R
authors.lastname: Suojaranta-Ylinen
authors.forename: E
authors.initials: E
authors.lastname: Hammarén
authors.forename: V K
authors.initials: VK
authors.lastname: Kontinen
authors.forename: P
authors.initials: P
authors.lastname: Raivio
authors.forename: P
authors.initials: P
authors.lastname: Tarkkila
authors.forename: P H
authors.initials: PH
authors.lastname: Rosenberg
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage*; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects; D006348:Cardiac Surgical Procedures; D003221:Confusion / Q000139:chemically induced; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D010098:Oxycodone / Q000008:administration & dosage / Q000009:adverse effects; D010147:Pain Measurement / Q000379:methods; D010149:Postoperative Pain / Q000517:prevention & control*; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications; D020250:Postoperative Nausea and Vomiting / Q000139:chemically induced; D000069583:Pregabalin; D005680:gamma-Aminobutyric Acid / Q000008:administration & dosage / Q000031:analogs & derivatives*
chemical_list: D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D000069583:Pregabalin; D005680:gamma-Aminobutyric Acid; D010098:Oxycodone