Successful management of postoperative pain with pregabalin after thoracotomy.
OBJECTIVE
There is no established treatment for intercostal neuralgia associated with thoracotomy. We investigated the administration of pregabalin as a new perioperative treatment, assessing its safety and efficacy for intercostal neuralgia after thoracotomy.


METHODS
Thirty patients suffering pain after thoracotomy severe enough to cause insomnia were prospectively enrolled and treated with 150 mg of pregabalin. We evaluated pain scores (Numeric Rating Scale, NRS), severity of nocturnal insomnia, and adverse effects before and after pregabalin administration.


RESULTS
We noted significant decreases in pain scores, before vs. after pregabalin administration, from 8.2 ± 1.3 to 3.4 ± 1.3 (p < 0.0001), with improvement in nocturnal insomnia in 29 out of 30 patients. Eight patients reported adverse effects, including dizziness and daytime drowsiness; however, by reducing the dose of pregabalin, these effects were minimized while pain was controlled well.


CONCLUSIONS
Pregabalin was highly effective for neuralgia associated with intercostal damage after thoracotomy.
Department of Surgery, Teikyo University School of Medicine, 2-11-1 Kaga Itabashi-ku, Tokyo, 173-8605, Japan, matsutani1970@yahoo.co.jp.
Noriyuki
N
Matsutani
Masafumi
M
Kawamura
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006801:Humans; D007367:Intercostal Nerves; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000188:drug therapy*; D010149:Postoperative Pain / Q000188:drug therapy*; D000069583:Pregabalin; D011446:Prospective Studies; D013908:Thoracotomy; D016896:Treatment Outcome; D055815:Young Adult; D005680:gamma-Aminobutyric Acid / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*
D000700:Analgesics; D000069583:Pregabalin; D005680:gamma-Aminobutyric Acid