title: Perioperative pregabalin for reducing pain, analgesic consumption, and anxiety and enhancing sleep quality in elective neurosurgical patients: a prospective, randomized, double-blind, and controlled clinical study.
abstract: OBJECTIVE The aim of this study was to assess in-hospital (immediate) postoperative pain scores and analgesic consumption (primary goals) and preoperative anxiety and sleep quality (secondary goals) in patients who underwent craniotomy and were treated with pregabalin (PGL). Whenever possible, out-of-hospital pain scores and analgesics usage data were obtained as well. METHODS This prospective, randomized, double-blind and controlled study was conducted in consenting patients who underwent elective craniotomy for brain tumor resection at Tel Aviv Medical Center between 2012 and 2014. Patients received either 150 mg PGL (n = 50) or 500 mg starch (placebo; n = 50) on the evening before surgery, 1.5 hours before surgery, and twice daily for 72 hours following surgery. All patients spent the night before surgery in the hospital, and no other premedication was administered. Opioids and nonsteroidal antiinflammatory drugs were used for pain, which was self-rated by means of a numerical rating scale (score range 0-10). RESULTS Eighty-eight patients completed the study. Data on the American Society of Anesthesiologists class, age, body weight, duration of surgery, and intraoperative drugs were similar for both groups. The pain scores during postoperative Days 0 to 2 were significantly lower in the PGL group than in the placebo group (p < 0.01). Analgesic consumption was also lower in the PGL group, both immediately and 1 month after surgery. There were fewer requests for antiemetics in the PGL group, and the rate of postoperative nausea and vomiting was lower. The preoperative anxiety level and the quality of sleep were significantly better in the PGL group (p < 0.01). There were no PGL-associated major adverse events. CONCLUSIONS Perioperative use of twice-daily 150 mg pregabalin attenuates preoperative anxiety, improves sleep quality, and reduces postoperative pain scores and analgesic usage without increasing the rate of adverse effects. Clinical trial registration no.: NCT01612832 ( clinicaltrials.gov ).
authors: Neurosurgery, Tel Aviv Sourasky Medical Center and the Sackler Faculty of Medicine at the Tel Aviv University, Tel Aviv, Israel.
authors: Nir
authors: N
authors: Shimony
authors: Departments of 1 Anesthesia and Post-Anesthesia Care Unit and.
authors: Uri
authors: U
authors: Amit
authors: Neurosurgery, Tel Aviv Sourasky Medical Center and the Sackler Faculty of Medicine at the Tel Aviv University, Tel Aviv, Israel.
authors: Bella
authors: B
authors: Minz
authors: Neurosurgery, Tel Aviv Sourasky Medical Center and the Sackler Faculty of Medicine at the Tel Aviv University, Tel Aviv, Israel.
authors: Rachel
authors: R
authors: Grossman
authors: Departments of 1 Anesthesia and Post-Anesthesia Care Unit and.
authors: Marc A
authors: MA
authors: Dany
authors: Neurosurgery, Tel Aviv Sourasky Medical Center and the Sackler Faculty of Medicine at the Tel Aviv University, Tel Aviv, Israel.
authors: Lior
authors: L
authors: Gonen
authors: Neurosurgery, Tel Aviv Sourasky Medical Center and the Sackler Faculty of Medicine at the Tel Aviv University, Tel Aviv, Israel.
authors: Karina
authors: K
authors: Kandov
authors: Neurosurgery, Tel Aviv Sourasky Medical Center and the Sackler Faculty of Medicine at the Tel Aviv University, Tel Aviv, Israel.
authors: Zvi
authors: Z
authors: Ram
authors: Departments of 1 Anesthesia and Post-Anesthesia Care Unit and.
authors: Avi A
authors: AA
authors: Weinbroum
mesh_terms: D000700:Analgesics / Q000008:administration & dosage*; D001007:Anxiety / Q000517:prevention & control*; D003399:Craniotomy; D004311:Double-Blind Method; D004363:Drug Utilization / Q000706:statistics & numerical data; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D019990:Perioperative Care; D000069583:Pregabalin / Q000008:administration & dosage*; D011446:Prospective Studies; D011788:Quality of Life; D012890:Sleep; D013997:Time Factors
chemical_list: D000700:Analgesics; D000069583:Pregabalin
keywords: ASA = American Society of Anesthesiologists; LOS = length of stay; MOE = morphine equivalent; NRS = numerical rating scale; NSAID = nonsteroidal antiinflammatory drug; PACU = postanesthesia care unit; PGL = pregabalin; POD = postoperative day; PONV = postoperative nausea and vomiting; analgesia; anxiety; craniotomy; pain; perioperative; pregabalin