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I talked with my brother-in-law who is an anesthesiologist at a large teaching hospital in the east about pain management after my upcoming back surgery. In the course of our telephone conversation, he mentioned something called pregabalin but I forgot to ask him more about it. What can you tell me?
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We found a recent study on the use of this drug following lumbar spinal fusion surgery that might be of some interest to you.
In this study, anesthesiologists compared different dosages (amounts) of this drug called pregabalin for postoperative pain control after lumbar spinal fusion. Pregabalin has been selected as a possible adjunct (helper) treatment because it is quickly absorbed and acts in a predictable and safe manner.
Pregabalin works because it blocks the release of neurotransmitters (chemical messengers) that tend to overexcite the nervous system, ramping up pain messages. Pregabalin is already in use but the optimal dosage for this purpose is unknown. That's where this study comes in.
Patients were assigned to one of the three groups randomly. One group received 75 mg of pregabalin one hour before surgery and again 12 hours after surgery. The second group was given twice that amount of drug (150 mg) at the same time periods. The third group was the placebo (control) group. They were given fake pills. No one taking the pills knew which group they were in.
The results of this experiment were measured in terms of pain intensity, amount of opioid medication used after surgery, and frequency of rescue analgesics required in the first 48 hours after surgery. Rescue analgesics refer to additional pain relievers needed to get control of pain because pain intensity has increased too much and the patient is very uncomfortable.
After collecting and analyzing all the data, they found that the higher dose of pregabalin (150 mg) was much more effective in controlling postoperative pain. The group receiving the higher dose used much less narcotic for pain control in the 48 hours after surgery. Symptoms after surgery were similar in all three groups, so clearly the pregabalin at any dose did not compromise the patients in any way.
The need for additional rescue medications was also reduced in the 150 mg group. With less pain after surgery, there is an added benefit: reduced risk of becoming a chronic pain patient.
The authors concluded that although 150 mg of pregabalin before and after lumbar spinal fusion surgery reduced postoperative pain, they still don't know if this is the optimal dose. Likewise, there's room for further study of the timing of the drug administration. This study only reviewed lumbar spinal fusion, so other studies looking at other surgeries may yield different results.
For now we know that 150 mg of pregabalin is more effective in pain control than 75 mg (or placebo). The 75 mg dosage was about as helpful as the placebo, so it may be possible to reduce the amount of pregabalin given but not down to 75 mg.
The optimal dose may be somewhere between 75 and 150 mg -- or it could be at a level greater than the 150 mg tested in this study. Future studies with different doses while monitoring side effects are still needed.
It's possible your surgeon is already aware of the use of pregabalin for pain control after spinal surgery. He or she may even be using it routinely. Let him or her know of your brother-in-law's suggestion and see if you might be a good candidate for use of this particular medication.
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*Disclaimer:*The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic. |
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