Analgesic efficacy of pregabalin in acute postmastectomy pain: placebo controlled dose ranging study.
OBJECTIVE
We hypothesized that oral administration of a single dose of pregabalin 2 hours before modified radical mastectomy (MRM) would produce dose-related reduction in postoperative opioid consumption.


METHODS
Prospective randomized controlled clinical trial.


METHODS
Postanesthesia care unit.


METHODS
One hundred twenty adult women scheduled for unilateral (MRM) with axillary evacuation.


METHODS
Patients were randomized to receive either, placebo capsule, pregabalin 75 mg, pregabalin 150 mg, or pregabalin 300 mg.


METHODS
The assessment parameters were the postoperative analgesic effect using visual analog scale (VAS) pain scores, the subsequent 24-hour morphine consumption, and the systemic adverse effects of pregabalin doses.


RESULTS
The VAS score at rest and movement was significantly decreased only in group P300 and group P150 in comparison to group P0 and group P75 at 0 hour (P<.01). The median (interquartile range) consumption of morphine in the first postoperative 24 hours was significantly decreased in group P300 in comparison to group P0 and group P75 (P300 vs P0: 6.5 [5-6.5] vs 20.5 [15.8-20.5] [P<.001]; P300 vs P75: 6.5 [5-6.5] vs 20 [14-20] [P<.001]), but there was no significant difference between group P300 and group P150. In addition, there was a significant decrease in consumption of morphine in group P150 in comparison to group P0 and group P75 (P150 vs P0: 7 [5-7] vs 20.5 [15.8-20.5] [P<.001]; P150 vs P75: 7 [5-7] vs 20 [14-20] [P<.001]). There were statistical significant increase in dizziness and blurred vision in group P300 in comparison to other groups (P<.05).


CONCLUSIONS
A single preoperative oral dose of pregabalin 150 mg is an optimal dose for reducing postoperative pain and morphine consumption in patients undergoing MRM.
Anesthesia and Pain Management, South Egypt Cancer Institute, Assiut University, Assiut, Egypt. Electronic address: diabhetta25@gmail.com.
Diab Fuad
DF
Hetta
Anesthesia and Pain Management, South Egypt Cancer Institute, Assiut University, Assiut, Egypt. Electronic address: abdelfatahmontaser69@yahoo.com.
Montaser A
MA
Mohamed
Anesthesia and Pain Management, South Egypt Cancer Institute, Assiut University, Assiut, Egypt. Electronic address: mfaroukma@gmail.com.
Mohammad Farouk
MF
Mohammad
D000328:Adult; D000700:Analgesics / Q000008:administration & dosage* / Q000009:adverse effects; D000701:Analgesics, Opioid / Q000008:administration & dosage; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D015411:Mastectomy, Modified Radical / Q000379:methods*; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D000069583:Pregabalin / Q000008:administration & dosage* / Q000009:adverse effects; D011446:Prospective Studies; D013997:Time Factors
D000700:Analgesics; D000701:Analgesics, Opioid; D000069583:Pregabalin; D009020:Morphine
Analgesic; Mastectomy; Perioperative; Pregabalin