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. 2017 Oct;9(10):3766-3773.
doi: 10.21037/jtd.2017.09.78.

Impact of pregabalin on early phase post-thoracotomy pain compared with epidural analgesia

Noriyuki Matsutani  1 , Hitoshi Dejima  1 , Takashi Nakayama  1 , Yusuke Takahashi  1 , Hirofumi Uehara  1 , Hisae Iinuma  1 , Toshiya Harashima  2 , Kazuki Anraku  2 , Masafumi Kawamura  1
Affiliations

Impact of pregabalin on early phase post-thoracotomy pain compared with epidural analgesia

Noriyuki Matsutani et al. J Thorac Dis. 2017 Oct.

Abstract

Background: The purpose of this randomized study was to compare the effects of pregabalin with epidural analgesia on early phase post-thoracotomy pain.

Methods: This study was conducted on 90 adult patients who underwent thoracotomy. Patients were randomly divided into two groups, an epidural analgesia group, where 45 patients received 0.2% ropivacaine hydrochloride and fentanyl through a thoracic epidural catheter, and a pregabalin group, where 45 patients received 75 mg pregabalin orally twice daily. Both groups were also administered orally with celecoxib along with each treatment. Numerical rating scale (NRS) and sleep interference rate (SIR) were evaluated on the first day, third day, and fifth day after surgery. Anesthetic induction time, operation time, recovery time, the use of additional analgesic drugs and adverse effects were also examined.

Results: NRS and SIR were significantly lower in the pregabalin group at all time points (P<0.05). The number of patients requiring additional analgesic drugs within 24 hours after surgery showed no difference between the two groups; however, the number was significantly decreased in the pregabalin group after post-operative day 1 (P<0.001). Adverse effects including pneumonia, dysuria, constipation and nausea were identified among many patients in the epidural analgesia group (P<0.05). Operation time and recovery time were the same for both groups, while the epidural analgesia group showed a significantly longer anesthetic induction time (P<0.001).

Conclusions: Pregabalin is considered to be a safe and effective treatment method which is an alternative to epidural analgesia for acute post-thoracotomy pain.

Keywords: Pregabalin; acute pain management; epidural analgesia; post-thoracotomy pain.

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
The CONSORT diagram of the study.
Figure 2
Figure 2
The postoperative pain scores (NRS). Pain is expressed as mean NRS; bars SD. *, P<0.05 compared with epidural analgesia by Mann-Whitney U-test. POD, post-operative day; NRS, numeric rating scale.
Figure 3
Figure 3
The SIR. Sleep interference is expressed as mean sleep interference rate; bars SD. *, P<0.05 compared with epidural analgesia by Mann-Whitney U-test. POD, post-operative day; SIR, sleep interference rate.
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