Oral Pregabalin in Cardiac Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

The efficacy of pregabalin for pain control after thoracic surgery: a meta-analysis

BACKGROUND

Pregabalin may have some potential in alleviating pain after thoracic surgery, and this meta-analysis aims to explore the impact of pregabalin on pain intensity for patients undergoing thoracic surgery.

METHODS

PubMed, EMbase, Web of science, EBSCO and Cochrane library databases were systematically searched, and we included randomized controlled trials (RCTs) assessing the effect of pregabalin on pain intensity after thoracic surgery.

RESULTS

Five RCTs were finally included in the meta-analysis. Overall, compared with control intervention for thoracic surgery, pregabalin was associated with significantly reduced pain scores at 0 h (mean difference [MD]=-0.70; 95% confidence interval [CI]=-1.10 to -0.30; P = 0.0005), pain scores at 24 h (MD=-0.47; 95% CI=-0.75 to -0.18; P = 0.001) and neuropathic pain (odd ratio [OR] = 0.24; 95% CI = 0.12 to 0.47; P < 0.0001), but demonstrated no obvious impact on the incidence of dizziness (OR = 1.07; 95% CI = 0.15 to 7.46; P = 0.95), headache (OR = 1.00; 95% CI = 0.30 to 3.35; P = 1.00) or nausea (OR = 1.24; 95% CI = 0.46 to 3.35; P = 0.68).

CONCLUSIONS

Pregabalin may be effective to alleviate the pain after thoracic surgery.

Analgesic Efficacy of Gabapentin and Pregabalin in Patients Undergoing Laparoscopic Bariatric Surgeries: a Systematic Review and Meta-analysis

This meta-analysis investigated the effect of oral gabapentinoids (i.e., pregabalin and gabapentin) on analgesic consumption (i.e., primary outcome) and pain relief (i.e., secondary outcome) in patients following bariatric surgery. Analysis of five eligible trials published between 2010 and 2019 including 363 participants receiving gabapentinoids revealed a significantly lower morphine consumption [mean difference (MD) =  - 15.1 mg, p = 0.004; evidence certainty: low] and risk of nausea/vomiting [risk ratio (RR) = 0.49, p = 0.002; evidence certainty: high] at postoperative 6-24 h. There was also a lower pain score at postoperative 0-4 h (MD =  - 1.41, p < 0.00001; evidence certainty: low) and 6-12 h (MD =  - 0.9, p = 0.007; evidence certainty: low) compared with controls, while pain severity at postoperative 24 h was comparable between two groups. In summary, preoperative oral gabapentinoids optimized postoperative pain outcomes and reduced risk of nausea/vomiting following bariatric surgery.