pregabalin and Rotator-Cuff-Injuries

To compare the analgesic effects of pregabalin to those of single-shot interscalene brachial plexus block (ISBPB) in adults having arthroscopic rotator cuff (RC) repair, as well as ISBPB's effect on postoperative opioid consumption, patient satisfaction, and opioid-related adverse effects.. In this randomized trial, 79 adults having arthroscopic RC repair were randomized to receive perioperative oral pregabalin (Lyrica, twice daily starting the evening before surgery, for a total of 4 doses) or single-shot ISBPB (20 ml of bupivacaine 0.25%). Intra- and postoperative management was standardized. The primary outcome was median self-reported pain score (on a visual analog scale of 0 to 100) at rest during the initial 10 postoperative days. Other outcomes included pain during activity, postoperative opioid consumption, opioid-related adverse effects, quality of recovery, and pain satisfaction score.. Of 71 eligible patients, 59 were analyzed, of whom 29 received pregabalin and 30 received ISBPB. Groups were similar regarding demographic, baseline, and intraoperative variables. Median pain score at rest over the 10 postoperative days was 51 (interquartile range 26, 76) in the pregabalin group and 52 (22, 74) in the ISBPB group (difference 0.5 points; 95% confidence interval [CI] -3.2 to 6.3; P = .53). Opioid consumption during the initial 10 postoperative days was also similar (difference in median 90 mg of morphine equivalents; 95% CI -32 to 177.5; P = .12). No differences were found in any other outcome.. Perioperative use of pregabalin in adults undergoing arthroscopic RC repair provided analgesia comparable to that of ISBPB for 10 days after surgery.. II, randomized controlled trial (high dropout rate).

Topics: Adult; Anesthetics, Local; Arthroscopy; Brachial Plexus Block; Humans; Pain, Postoperative; Pregabalin; Rotator Cuff; Rotator Cuff Injuries

Considering the adverse effects of opioids, it is essential to minimize their consumption for postoperative pain control. Studies have reported the opioid sparing effects of pregabalin, with conflicting results. Evidence for administering pregabalin in a multimodal regimen after arthroscopic rotator cuff repair surgery is limited.. A total of 64 patients who underwent arthroscopic rotator cuff repair were enrolled in the cohort, and their data were retrospectively analyzed to evaluate the ability of pregabalin for postoperative analgesia and opioid sparing. The pregabalin group (n = 32) received additional pregabalin 75 mg for 2 weeks from the day before the surgery with the standard pain medications; in contrast, the control group (n = 32) was prescribed the standard pain medications alone. The total volume of patient-controlled anesthesia, doses of oral oxycodone and intravenous morphine as rescue analgesics, number of adverse events, and patient satisfaction based on the numeric rating scale (0-10) were assessed. Further, we used the visual analog scale for evaluating pain and function for 6 months in each group.. Total patient-controlled anesthesia volume, number of patient-controlled anesthesia attempts on the day of surgery, and total oral oxycodone consumption were significantly lower in the pregabalin group. Visual analog scale scores for pain and function showed no significant differences. Although the total number of adverse effects (nausea, vomiting, dizziness, dry mouth, urinary retention, itching sense, or constipation) was higher in the pregabalin group than in the control group, the difference was not statistically significant.. Our multimodal regimen with pregabalin significantly reduced opioid consumption with similar adverse effects. However, there was no significant difference in the pain score. We recommend pregabalin as an additional analgesic for arthroscopic rotator cuff repairs, especially for medium to large sized tears.

Topics: Analgesics; Analgesics, Opioid; Arthroscopy; Humans; Pain, Postoperative; Pregabalin; Retrospective Studies; Rotator Cuff; Rotator Cuff Injuries