Document Detail


Perioperative pregabalin for postoperative pain control and quality of life after major spinal surgery.
MedLine Citation:
PMID:  22045156     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Adequate management of postoperative pain after major spine surgery is often difficult to achieve. We investigated the efficacy of an antineuropathic pain drug, pregabalin (PG), on postoperative pain control and on improvement of quality of life (QoL).
METHODS: Sixty patients scheduled for elective decompressive spine surgery were enrolled. One hour before surgery patients received 300 mg of either oral PG or placebo (PL) and 150 mg of PG or PL twice a day for 48 hours postoperatively. During the first 48 postoperative hours, a continuous infusion of morphine 0.01 mg/kg/h and ketorolac tromethamine 2.5 mg/h was administered. Intravenous morphine in 2-mg aliquots up to a maximum of 10 mg was used as rescue therapy. Pain was measured at rest and during movement using a visual analog scale (VAS score), and side effects were recorded in the first hour and at 4, 8, 12, 24, and 48 hours. Three months and 1 year after discharge, patients were contacted by telephone by 1 of the authors to obtain follow-up information using the EuroQoL questionnaire.
RESULTS: During the first 8 postoperative hours, VAS scores at rest were significantly lower in the PG group than in the PL group (P<0.05), whereas VAS scores on movement were significantly lower up to 12 hours after the operation in the PG group (P<0.05). The morphine consumption in the PG group was 3±2 mg, whereas in the PL group it was 9.5±2.5 mg (P<0.05). Postoperative incidence of constipation and nausea/vomiting was higher in the PL group than in the PG group. No significant differences between the 2 groups were observed with regard to other adverse effects. QoL measures revealed an improvement in outcome, especially in movement and in pain dimensions in both groups; however, at 3 months, subjective qualification of overall QoL was better in the PG group than in the PL group. There were no differences in QoL after the 1-year follow-up period.
CONCLUSIONS: Perioperative PG administration reduces early postsurgical pain at rest and particularly during movement after major spine surgery with less opioid consumption, and it seems to influence the improvement of overall QoL 3 months after surgery.
Authors:
Lara Gianesello; Vittorio Pavoni; Elisabetta Barboni; Ilaria Galeotti; Alessandra Nella
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Journal of neurosurgical anesthesiology     Volume:  24     ISSN:  1537-1921     ISO Abbreviation:  J Neurosurg Anesthesiol     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-03-05     Completed Date:  2012-07-26     Revised Date:  2013-08-21    
Medline Journal Info:
Nlm Unique ID:  8910749     Medline TA:  J Neurosurg Anesthesiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  121-6     Citation Subset:  IM    
Affiliation:
Department of Anesthesia and Intensive Care, University-Hospital Careggi, Largo Palagi, Firenze, Italy. gianesello.lara@libero.it
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MeSH Terms
Descriptor/Qualifier:
Aged
Analgesics / therapeutic use*
Analgesics, Opioid / administration & dosage
Anti-Inflammatory Agents, Non-Steroidal / administration & dosage
Double-Blind Method
Drug Administration Schedule
Female
Follow-Up Studies
Humans
Ketorolac Tromethamine / administration & dosage
Male
Middle Aged
Morphine / administration & dosage
Pain Measurement / methods
Pain, Postoperative / drug therapy*
Perioperative Care / methods*
Prospective Studies
Quality of Life*
Questionnaires
Spine / surgery*
Treatment Outcome
gamma-Aminobutyric Acid / analogs & derivatives*,  therapeutic use
Chemical
Reg. No./Substance:
0/Analgesics; 0/Analgesics, Opioid; 0/Anti-Inflammatory Agents, Non-Steroidal; 55JG375S6M/pregabalin; 56-12-2/gamma-Aminobutyric Acid; 57-27-2/Morphine; 74103-07-4/Ketorolac Tromethamine
Comments/Corrections
Comment In:
J Neurosurg Anesthesiol. 2012 Oct;24(4):427; author reply 427   [PMID:  22885671 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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