Combination of pregabalin and dexamethasone for postoperative pain and functional outcome in patients undergoing lumbar spinal surgery: a randomized placebo-controlled trial

Clin J Pain. 2013 Jan;29(1):9-14. doi: 10.1097/AJP.0b013e318246d1a9.

Abstract

Objectives: In this randomized-controlled study, we investigated the effects of combined administration of pregabalin and dexamethasone on postoperative pain and analgesic requirements, and functional outcome in patients who underwent lumbar spinal surgery.

Methods: One hundred eight patients were randomized to group C (placebo+placebo), group P (pregabalin + placebo), or group PD (pregabalin+dexamethasone). According to their allocated group, patients received placebo or pregabalin 150 mg every 12 hours starting 1 hour before anesthetic induction for a total of 8 doses. Dexamethasone 16 mg or normal saline was injected before the induction of anesthesia. The pain intensity, analgesic requirements, and side effects were assessed in the postoperative period: postanesthesia care unit, 12, 24, 48, and 72 hours. Pain intensity and daily activity performance were also assessed 1, 3, and 6 months after surgery.

Results: Compared with group C, the pain scores were lower in group PD at 24 hours after surgery (P = 0.011). The frequency of additional rescue analgesic administration was significantly lower in group PD until 48 hours after surgery (P < 0.05) and in group P at 24 to 48 hours (P = 0.005) relative to group C. Back pain intensity at work was lower (P = 0.048) and daily activity performance was better (P = 0.006) in group PD compared with group C at 1 month after surgery.

Conclusions: Combined administration of pregabalin and dexamethasone conferred analgesic benefits superior to those of pregabalin alone. This regimen also helped facilitate return to normal daily activity after surgery.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Activities of Daily Living
  • Adult
  • Aged
  • Analgesics / administration & dosage
  • Anti-Inflammatory Agents / administration & dosage
  • Dexamethasone / administration & dosage*
  • Drug Therapy, Combination
  • Female
  • Humans
  • Laminectomy / statistics & numerical data*
  • Lumbar Vertebrae / surgery*
  • Male
  • Middle Aged
  • Pain Measurement / drug effects
  • Pain Measurement / statistics & numerical data
  • Pain, Postoperative / diagnosis
  • Pain, Postoperative / drug therapy*
  • Pain, Postoperative / epidemiology
  • Placebo Effect
  • Pregabalin
  • Premedication / methods
  • Premedication / statistics & numerical data*
  • Recovery of Function
  • Republic of Korea / epidemiology
  • Treatment Outcome
  • Young Adult
  • gamma-Aminobutyric Acid / administration & dosage
  • gamma-Aminobutyric Acid / analogs & derivatives*

Substances

  • Analgesics
  • Anti-Inflammatory Agents
  • Pregabalin
  • gamma-Aminobutyric Acid
  • Dexamethasone