Effect of Perioperative Pregabalin on Postoperative Quality of Recovery in Patients Undergoing Off-Pump Coronary Artery Bypass Grafting (OPCABG): A Prospective, Randomized, Double-Blind Trial

J Cardiothorac Vasc Anesth. 2017 Aug;31(4):1241-1245. doi: 10.1053/j.jvca.2016.09.029. Epub 2016 Sep 28.

Abstract

Objectives: Use of pregabalin is increasing in cardiac surgical patients. However, studies using comprehensive scoring systems are lacking on the drug's impact on postoperative recovery. The authors tested the hypothesis that perioperative oral pregabalin improves the postoperative quality of recovery as assessed using the Quality of Recovery (QoR-40) questionnaire in patients undergoing off-pump coronary artery bypass grafting (OPCABG).

Design: This was a randomized, double-blind, placebo-controlled study.

Settings: Tertiary-care hospital.

Participants: Patients undergoing OPCABG.

Interventions: Patients were assigned randomly to the following 2 groups: the pregabalin group (those who received pregabalin, 150 mg capsule orally, 1 hour before surgery and 2 days postoperatively [75 mg twice a day] starting after extubation; n = 37); and the control group (those who received 2 similar-looking multivitamin capsules at similar times; n = 34). The QoR-40 scores were noted preoperatively and 24 hours after extubation.

Measurements and main results: Both groups were comparable in terms of preoperative patient characteristics and baseline QoR-40 scores. Global scores were significantly improved in the pregabalin group compared with the control group in the postoperative period (177±9 v 170±9; p = 0.002). QoR-40 values in the dimensions of emotional state (p = 0.005), physical comfort (p = 0.04), and pain (p = 0.02) were improved in the pregabalin group.

Conclusions: Perioperative pregabalin improved postoperative quality of recovery as assessed using the QoR-40 questionnaire in patients undergoing OPCABG. Perioperative pregabalin offered advantages beyond better pain control, such as improved physical comfort and better emotional state; therefore, the drug's use in the perioperative period is recommended.

Keywords: Quality of Recovery-40; off-pump coronary artery bypass grafting; pregabalin.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Analgesics / administration & dosage*
  • Coronary Artery Bypass / adverse effects*
  • Coronary Artery Bypass / trends
  • Double-Blind Method
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pain Measurement / methods
  • Pain, Postoperative / diagnosis
  • Pain, Postoperative / prevention & control
  • Perioperative Care / methods*
  • Postoperative Care / methods*
  • Pregabalin / administration & dosage*
  • Prospective Studies
  • Recovery of Function / drug effects*
  • Recovery of Function / physiology
  • Treatment Outcome

Substances

  • Analgesics
  • Pregabalin