title: The effect of pregabalin and celecoxib on the analgesic requirements after laparoscopic cholecystectomy: a randomized controlled trial.
abstract: OBJECTIVE
  Early postoperative pain is a common complaint after elective laparoscopic cholecystectomy. The use of non-opioid medications as a part of multimodal analgesia has been increasingly advocated in the management of acute post-surgical pain. This randomized, double-blinded, placebo-controlled study evaluated the efficacy of pregabalin, celecoxib, and their combination in the management of acute postoperative pain in patients undergoing elective laparoscopic cholecystectomy.
  
  
  METHODS
  One hundred ASA I/II patients scheduled to undergo elective laparoscopic cholecystectomy were assigned to receive two perioperative doses, 12 h apart, of either pregabalin alone, celecoxib alone, their combination, or a placebo. Standard anesthetic protocol was followed. The primary outcomes were postoperative pain at rest and with movement. Secondary outcomes were fentanyl requirements and side effects, which were assessed at 1, 2, 4, 8, 12, and 24 h following surgery. Patient satisfaction with pain relief was recorded at discharge. Differences in main outcomes were analyzed using an intention-to-treat approach.
  
  
  RESULTS
  There was no statistically significant difference (p > 0.05) between the four groups in terms of outcomes such as rest pain, movement pain, postoperative fentanyl requirements, or changes in anxiety scores. Patients who had only celecoxib had significantly higher satisfaction with pain management (p = 0.013). Patients who had only pregabalin were at three-times-higher odds of having drowsiness (p = 0.040) and four-times-higher odds of having lightheadedness (p = 0.019) when compared with the placebo group.
  
  
  CONCLUSIONS
  Pregabalin, celecoxib alone, or in combination offers no analgesic superiority over standard opioid care in the treatment of postoperative pain following laparoscopic cholecystectomy.
authors.affiliation: Department of Anesthesia and Perfusion Services, The Prince Charles Hospital and School of Medicine, University of Queensland, Brisbane, Australia. usha.gurunathan@health.qld.gov.au.
authors.forename: Usha
authors.initials: U
authors.lastname: Gurunathan
authors.affiliation: Department of Anesthesia and Perfusion Services, The Prince Charles Hospital and School of Medicine, University of Queensland, Brisbane, Australia.
authors.forename: Ivan L
authors.initials: IL
authors.lastname: Rapchuk
authors.affiliation: Surgical Preadmission Clinic, The Prince Charles Hospital, Brisbane, Australia.
authors.forename: Gillian
authors.initials: G
authors.lastname: King
authors.affiliation: Queensland University of Technology, Brisbane, Australia.
authors.forename: Adrian G
authors.initials: AG
authors.lastname: Barnett
authors.affiliation: Intensive Care Unit, CCRG, The Prince Charles Hospital, University of Queensland, Brisbane, Australia.
authors.forename: John F
authors.initials: JF
authors.lastname: Fraser
mesh_terms: D000328:Adult; D000368:Aged; D000700:Analgesics / Q000008:administration & dosage; D000701:Analgesics, Opioid / Q000008:administration & dosage; D000068579:Celecoxib / Q000008:administration & dosage*; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects / Q000379:methods*; D004311:Double-Blind Method; D017558:Elective Surgical Procedures / Q000379:methods; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000188:drug therapy*; D017060:Patient Satisfaction; D000069583:Pregabalin / Q000008:administration & dosage*; D011446:Prospective Studies
chemical_list: D000700:Analgesics; D000701:Analgesics, Opioid; D000069583:Pregabalin; D000068579:Celecoxib; D005283:Fentanyl
keywords: Celecoxib; Laparoscopic cholecystectomy; Postoperative pain; Pregabalin