title: Evaluation of postoperative pregabalin for attenuation of postoperative shoulder pain after thoracotomy in patients with lung cancer, a preliminary result.
abstract: OBJECTIVE
  Thirty-one to 97% of patients who undergo thoracotomy for lung cancer experience ipsilateral shoulder pain, marring the otherwise excellent relief provided by thoracic epidural analgesia. The aim of this study was to test whether the addition of pregabalin to the treatment for shoulder pain would provide a significant benefit.
  
  
  METHODS
  Twenty patients undergoing thoracic surgery for lung cancer were enrolled in the control group between May 2012 and December 2012, and 20 patients were enrolled in the pregabalin group between January 2013 and July 2013, consecutively. All patients had standard pre- and intraoperative care. Patients received pregabalin 150 mg po POD 1 and then non-steroidal anti-inflammatory drugs (NSAIDs) po 2 h later (pregabalin group), or they received only NSAIDs po at exactly the same times (control group). Pain severity was then measured using a 100-mm visual analog scale (VAS) scoring system.
  
  
  RESULTS
  The VAS scores indicated that patients in the pregabalin group had significantly less shoulder pain on postoperative day (POD) 2 than those in the control group (control: 27.9 ± 28.1 vs. pregabalin: 11.8 ± 14.4; p = 0.030). No differences in pain were observed between the two groups on other POD. There were significant differences on only POD 2 in the patients with shoulder pain immediately after surgery. Three of the pregabalin-treated patients showed mild somnolence.
  
  
  CONCLUSIONS
  Postoperative administration of pregabalin provided significant relief of postoperative shoulder pain during earlier POD after thoracic surgery for lung cancer when received multimodal analgesia in combination with NSAIDs.
authors.affiliation: Department of Anaesthesia, Nakadori General Hospital, Akita, Japan.
authors.forename: Yukako
authors.initials: Y
authors.lastname: Imai
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Imai
authors.forename: Tetsu
authors.initials: T
authors.lastname: Kimura
authors.forename: Takashi
authors.initials: T
authors.lastname: Horiguchi
authors.forename: Toru
authors.initials: T
authors.lastname: Goyagi
authors.forename: Hajime
authors.initials: H
authors.lastname: Saito
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Sato
authors.forename: Satoru
authors.initials: S
authors.lastname: Motoyama
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Nishikawa
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Minamiya
mesh_terms: D000328:Adult; D000368:Aged; D000700:Analgesics / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D010865:Pilot Projects; D011183:Postoperative Complications / Q000188:drug therapy; D000069583:Pregabalin; D020069:Shoulder Pain / Q000188:drug therapy*; D013908:Thoracotomy / Q000009:adverse effects*; D005680:gamma-Aminobutyric Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D000700:Analgesics; D000069583:Pregabalin; D005680:gamma-Aminobutyric Acid