Addition of pregabalin to multimodal analgesic therapy following ankle surgery: a
randomized double-blind, placebo-controlled trial.
Author(s): Yadeau JT, Paroli L, Kahn RL, Jules-Elysee KM, Lasala VR, Liu SS, Lin E, Powell
K, Buschiazzo VL, Wukovits B, Roberts MM, Levine DS.
Affiliation(s): Department of Anesthesiology, Hospital for Special Surgery, Weill Cornell Medical
College, NewYork, NY 10021, USA. firstname.lastname@example.org
Publication date & source: 2012, Reg Anesth Pain Med. , 37(3):302-7
BACKGROUND AND OBJECTIVES: Pregabalin is often used as a perioperative analgesic
adjunct; some studies show benefit, but others do not. Adverse effects, such as
confusion and sedation, have been attributed to perioperative use of pregabalin.
We tested the hypothesis that pregabalin, when used as part of a multimodal
analgesic regimen, reduces the duration of moderate to severe pain in the first
24 hrs following foot or ankle surgery. Secondary outcomes included measures of
opioid and pregabalin adverse effects.
METHODS: Sixty patients scheduled for hospital admission after foot or ankle
surgery entered this randomized, double-blind, placebo-controlled trial. Patients
received a neuraxial anesthetic, a popliteal fossa sciatic nerve block using 30
mL 0.375% bupivacaine with clonidine 100 µg and epinephrine, a saphenous nerve
block, postoperative hydromorphone intravenous patient-controlled analgesia, and
oral analgesics (oxycodone/acetaminophen). Patients were randomized to receive
pregabalin (100 mg preoperatively, then 50 mg every 12 hrs) or a placebo for 3
days. The primary outcome was the number of hours that patients reported moderate
to severe pain.
RESULTS: Both groups reported a similar number of hours of moderate to severe
pain during the first 24 hrs: 4.1 (SD, 4.1) hrs (pregabalin) versus 4.5 (SD, 3.5)
hrs (placebo). Pain scores, opioid use, and adverse effects were also similar in
CONCLUSIONS: No clinical benefit was obtained from perioperative administration
of pregabalin (100 mg preoperative, then 50 mg every 12 hrs) as part of a
multimodal postoperative analgesic regimen following foot and ankle surgery.