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
| Autor: | Marc A Dany, Zvi Ram, Bella Minz, Uri Amit, Lior Gonen, Nir Shimony, Rachel Grossman, Avi A Weinbroum, Karina Kandov |
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| Rok vydání: | 2016 |
| Předmět: |
Male
Time Factors Analgesic Pregabalin Anxiety Placebo Neurosurgical Procedures Perioperative Care 03 medical and health sciences 0302 clinical medicine Double-Blind Method 030202 anesthesiology Humans Medicine Prospective Studies Adverse effect Pain Measurement Analgesics Pain Postoperative business.industry General Medicine Perioperative Middle Aged Drug Utilization Elective Surgical Procedures Anesthesia Quality of Life Female Premedication medicine.symptom Sleep business Craniotomy 030217 neurology & neurosurgery Postoperative nausea and vomiting medicine.drug |
| Zdroj: | Journal of Neurosurgery. 125:1513-1522 |
| ISSN: | 1933-0693 0022-3085 0161-2832 |
| Popis: | 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) |
| Databáze: | OpenAIRE |
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