title: Impact of pregabalin on the occurrence of postthoracotomy pain syndrome: a randomized trial.
abstract: BACKGROUND
  Postthoracotomy pain syndrome (PTPS) is a frequent cause of chronic postoperative pain. Pregabalin might reduce the incidence of chronic postoperative pain. The goal of this study was to evaluate the impact of perioperative pregabalin on the occurrence of PTPS, defined as any surgical site pain 3 months after surgery.
  
  
  METHODS
  We conducted a randomized, placebo-controlled, double-blind trial in patients undergoing elective thoracotomy. Patients received either pregabalin 150 mg orally twice a day initiated 1 hour before thoracotomy and continued until 4 days after thoracotomy (10 doses total) or a placebo using the same protocol. All patients received preincision thoracic epidural analgesia. Postthoracotomy pain syndrome was evaluated using the Brief Pain Inventory questionnaire through a telephone interview. Secondary outcomes included evaluation of neuropathic characteristics through the Leeds Assessment of Neuropathic Symptoms and Signs questionnaire, analgesic use 3 months after surgery, and evaluation of acute postoperative pain and opioid consumption.
  
  
  RESULTS
  One hundred fourteen patients were randomized, and 99 patients completed the study (placebo, n = 49; pregabalin, n = 50). Postthoracotomy pain syndrome occurred in 49 (49.5%) of 99 patients and more frequently in the pregabalin group (31/50 [62%] vs 18/49 [37%] in the placebo group, P = 0.01). However, among patients with PTPS, those in the pregabalin group required significantly less analgesics, reported less moderate to severe average pain, and presented significantly less neuropathic characteristics than patients in the placebo group 3 months after surgery.
  
  
  CONCLUSIONS
  Pregabalin did not reduce the incidence of PTPS in this study. Future research on PTPS should focus on the impact of regional analgesia on central sensitization.
authors.affiliation: From the Departments of *Anesthesiology and †Thoracic Surgery, Maisonneuve-Rosemont and University of Montreal Hospital Centres, Montreal, Québec, Canada.
authors.forename: Véronique
authors.initials: V
authors.lastname: Brulotte
authors.forename: Monique M
authors.initials: MM
authors.lastname: Ruel
authors.forename: Edwin
authors.initials: E
authors.lastname: Lafontaine
authors.forename: Philippe
authors.initials: P
authors.lastname: Chouinard
authors.forename: François
authors.initials: F
authors.lastname: Girard
mesh_terms: D000700:Analgesics / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000188:drug therapy*; D000069583:Pregabalin / Q000627:therapeutic use*; D011446:Prospective Studies; D013577:Syndrome; D013908:Thoracotomy / Q000009:adverse effects*; D016896:Treatment Outcome
chemical_list: D000700:Analgesics; D000069583:Pregabalin