Pregabalin for Postoperative Analgesia after Idiopathic Scoliosis Surgery - Abstract
Introduction: Postoperative pain management in children after spinal surgery is a crucial issue that deserves much attention. Multimodal analgesia appears to be the most appropriate approach to optimize pain control. Pregabalin has proven its efficacy in improving postoperative pain scores and considerably reducing opioid consumption in adults. The aim of the study was to demonstrate the analgesic effect of pregabalin for postoperative pain relief after scoliosis surgery in adolescents.
Methods: Forty adolescents with idiopathic scoliosis scheduled to undergo a posterior corrective spinal surgery, were assigned to receive either pregabalin 150 mg orally (pregabalin group, n=20) or a placebo (control group, n=20) one hour before surgery and 12 hours postoperatively. Patient received also, paracetamol 15 mg/Kg four times per day, 20 mg of piroxicam orally twice-a-day and morphine administered via PCA pump, for 48 hours. Total
postoperative morphine consumption and severity of pain at rest and on movement using a 10 cm-Visual analogic scale pain score were measured 48 hours following surgery.
Results: Total 48-hour PCA morphine consumption was significantly lower in the pregabalin group than in the control group [mean (SD) 29.8 mg (13.2) vs. 43.1 mg (20.7), P=0.014]. However, there were no differences between groups in the median VAS pain scores at rest and on movement. No significant differences were found with regard to side effects in the initial 48 hours after surgery.
Conclusions: A per operative total dose of 300 mg oral pregabalin in adolescents undergoing surgical correction of idiopathic scoliosis, was associated with a significant reduction in 48-h morphine consumption.