Successful management of postoperative pain with pregabalin after thoracotomy

Surg Today. 2014 Apr;44(4):712-5. doi: 10.1007/s00595-013-0743-x. Epub 2013 Sep 27.

Abstract

Purpose: There is no established treatment for intercostal neuralgia associated with thoracotomy. We investigated the administration of pregabalin as a new perioperative treatment, assessing its safety and efficacy for intercostal neuralgia after thoracotomy.

Methods: Thirty patients suffering pain after thoracotomy severe enough to cause insomnia were prospectively enrolled and treated with 150 mg of pregabalin. We evaluated pain scores (Numeric Rating Scale, NRS), severity of nocturnal insomnia, and adverse effects before and after pregabalin administration.

Results: We noted significant decreases in pain scores, before vs. after pregabalin administration, from 8.2 ± 1.3 to 3.4 ± 1.3 (p < 0.0001), with improvement in nocturnal insomnia in 29 out of 30 patients. Eight patients reported adverse effects, including dizziness and daytime drowsiness; however, by reducing the dose of pregabalin, these effects were minimized while pain was controlled well.

Conclusion: Pregabalin was highly effective for neuralgia associated with intercostal damage after thoracotomy.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Analgesics / administration & dosage*
  • Analgesics / adverse effects
  • Female
  • Humans
  • Intercostal Nerves*
  • Male
  • Middle Aged
  • Neuralgia / drug therapy*
  • Pain, Postoperative / drug therapy*
  • Pregabalin
  • Prospective Studies
  • Thoracotomy*
  • Treatment Outcome
  • Young Adult
  • gamma-Aminobutyric Acid / administration & dosage
  • gamma-Aminobutyric Acid / adverse effects
  • gamma-Aminobutyric Acid / analogs & derivatives*

Substances

  • Analgesics
  • Pregabalin
  • gamma-Aminobutyric Acid