Pregabalin to improve postoperative recovery in bariatric surgery: a parallel, randomized, doubleblinded, placebo-controlled study

Abstract

Marcelo J Martins,1 Caroline Paiva Matos Oliveira Martins,2 Lucas J Castro-Alves,3 Gabriel Nascimento Jesus,4 Guilherme Oliveira Campos,5 Breno Barbosa Cerqueira Sacramento,4 Leonardo Ferrari Borges,6 Carlos Augusto Bastos Mello,6 Rodrigo Leal Alves,5 Norma Sueli Pinheiro Módolo7 1Department of Anesthesiology, São Paulo State University (UNESP), São Paulo, Brazil; 2Department of Anesthesiology at Federal University of Bahia, Bahia, Brazil; 3Department of Anesthesiology, Santo Antonio Hospital, Salvador, Bahia, Brazil; 4Department of Anesthesia, Bahia University of Medicine and Public Health, Bahia, Brazil, 5Department of Anesthesiology, Hospital Sao Rafael, Salvador, Bahia, Brazil; 6Department of Surgery, Hospital Tereza de Lisieux, Salvador, Bahia, Brazil; 7Department of Anaesthesiology, São Paulo State University (UNESP), Botucatu, Brazil Purpose: Obesity has been considered as a major public health problem in developed countries for which bariatric surgery has become an important treatment strategy. Postoperative pain, however, is a frequent problem in postoperative management. Pregabalin blocks the development of hyperalgesia and central pain sensitization. The objective of this randomized, placebo-controlled, double-blinded trial was to evaluate the effect of a single dose of preoperative pregabalin vs placebo on the quality of postoperative recovery in patients undergoing bariatric surgery.Patients and methods: A total of 70 patients undergoing abdominal gastroplasty were randomly assigned to receive oral pregabalin (75 mg) or an identical placebo 1 hour before surgery. The primary outcome was Quality of Recovery-40 (QoR-40) score at 24 hours. Secondary outcomes included opioid consumption and postoperative pain scores. P<0.05 was considered to indicate statistical significance.Results: In all, 60 of the 70 patients completed the study. The mean (SD) global recovery scores (QoR-40) 24 hours after surgery in the pregabalin and control groups were 183.7 (9) and 182.1 (12), respectively (mean difference=1.6, 95% CI –7.36 to 4.2, P=0.59). There was no significant difference in the total opioid consumption in the 24 hours following surgery between the two groups (pregabalin vs control=0.47×0.2; mean difference=0.26, 95% CI −0.24 to 0.77, P=0.3). There were no significant differences in nausea, vomiting, or time to postanesthesia care unit discharge between the two groups.Conclusion: In patients who underwent bariatric surgery, a single preoperative dose of pregabalin (75 mg) did not improve pain relief, quality of postoperative recovery, or reduction in opioid consumption.Clinical trial registration: http://www.ensaiosclinicos.gov.br (identifier: RBR-2g89x8). Keywords: gastroplasty, hyperalgesia, opioid

Keywords

• Gastroplasty
• Hyperalgesia
• Opioid