• Christophe Aveline, Le RouxAlainADepartment of Anesthesiology and Intensive Care, Sevigne Hospital, Cesson Sévigné, France., Bastien Le Touvet, Le HetetHubertHDepartment of Anesthesiology and Intensive Care, Sevigne Hospital, Cesson Sévigné, France., and Hélène Beloeil.
• Department of Anesthesiology and Intensive Care, Sevigne Hospital, Cesson Sévigné, France.
• Pain Physician. 2021 Jul 1; 24 (4): E501-E510.

BackgroundAlthough being controversial, pregabalin (PGB) is proposed during a short perioperative period  to improve pain relief.Comparisons between chronic and short-term users during lumbar spine surgery are lacking.ObjectivesThe purpose was to compare opioid requirements and postoperative pain among PGB chronic users and naive patients receiving a 48-hour perioperative administration.Study DesignProspective nonrandomized study.SettingTertiary care hospital.MethodsChronic users (group PGB, n = 39) continued their treatment, naive patients (group C, n = 43) received a dose of 150 mg preoperatively and 75 mg/12 hours for 48 hours. Anesthesia and analgesia were standardized. The primary outcome was the cumulative oxycodone consumption at 24 hours, other outcomes included pain scores, DN4 (Douleur Neuropathique 4 Questions) scores, and side effects.ResultsGroup PGB consumed less oxycodone at 24 hours (median [interquartile range] 10 mg [10-17.5] vs. 20 mg [10-20], P = 0.013], at 48 hours (15 mg [10-20] vs. 20 mg [12.5-30], P = 0.018), and required less intraoperative remifentanil (P = 0.004). Both groups showed similar pain scores during the 48-hour follow-up and at 3 months.Based on multivariate analysis, chronic users of PGB before surgery exhibited lower oxycodone requirements at 24 hours (odds ratio, 3.98; 95% confidence interval, 1.44-7.74; P = 0.008]. No differences were noted regarding side effects and DN4 scores.LimitationsNonrandomized study.ConclusionsPatients chronically treated with PGB required less opioid when compared with a short perioperative administration before spinal surgery. Further prospective studies are required to confirm these results in spinal surgeries.

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