title: [Benefits and safety of perioperative pregabalin: a systematic review].
abstract: OBJECTIVE
  Perioperative gabapentine administration improves analgesia, reduces postoperative nausea and vomiting, but increases sedation. Pregabalin is also a gabapentinoid, with an improved bioavailability. This systematic review evaluates the analgesic effect and tolerance of perioperative pregabaline.
  
  
  METHODS
  Systematic review.
  
  
  METHODS
  Systematic search in Pubmed database of clinical human randomized controlled studies dealing with perioperative administration of pregabalin. A quantitative review of pregabalin efficiency and an analysis of the main side effects reported in these studies was then performed.
  
  
  RESULTS
  Twenty-three study arms (884 patients) received at least one dose of pregabalin in 17 studies (totalizing 1577 patients). Pregabalin improved analgesia in 11 of 23 study arms. Pregabalin improved analgesia in three of 12 study arms after ambulatory surgery, and in eight of 11 after major surgery (P=0.04). Two of three studies about chronic postoperative pain revealed improved results in pregabalin groups. Nevertheless, pregabalin did not reduce postoperative nausea/vomiting, pruritus and headache, but increased trouble with vision, drowsiness, severe sedation and dizziness during the first postoperative hours, without severe clinical consequence. Severe sedation seemed clearly dose dependant, while drowsiness, dizziness or visual disturbance did not.
  
  
  CONCLUSIONS
  A favorable benefit risk-ratio is demonstrated only for major surgery (excluding ambulatory surgery). The lack of data concerning tolerance of pregabalin in the elderly and/or in case of renal dysfunction forbids any conclusion in these populations.
authors.affiliation: Pôle anesthésie-réanimation Samu, SAR2, hôpital Trousseau, CHRU de Tours, 2, boulevard Tonnelé, 37044 Tours cedex 9, France. f.remerand@chu-tours.fr
authors.forename: F
authors.initials: F
authors.lastname: Remérand
authors.forename: C
authors.initials: C
authors.lastname: Couvret
authors.forename: A
authors.initials: A
authors.lastname: Baud
authors.forename: M
authors.initials: M
authors.lastname: Laffon
authors.forename: J
authors.initials: J
authors.lastname: Fusciardi
mesh_terms: D000700:Analgesics / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D019990:Perioperative Care; D000069583:Pregabalin; D005680:gamma-Aminobutyric Acid / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D000700:Analgesics; D000069583:Pregabalin; D005680:gamma-Aminobutyric Acid