A comparative study of preemptive effect of pregabalin and gabapentin on postoperative pain after coronary artery bypass graft surgery. A clinical randomized trial

Background

Pain that pursues coronary artery bypass graft (CABG) surgery is usually associated with increased both recovery duration and hospital stay. Patient outcome could be worsened owing to large doses of opioids for pain control through over sedation, and prolonged mechanical ventilation. This study was designed to evaluate the effect of preemptive gabapentinoids on post CABG surgery pain control.

Methods

Sixty patients subjected to CABG were equally randomized to either receive 150 mg pregabalin, 600 mg gabapentin or identical capsule placebo, 2 hours before surgery. The postoperative pain was assessed with critical care pain observation tool (CPOT) and Numeric rate score (NRS). Total administered of patient controlled analgesia (PCA) with morphine as well as any rescue doses were registered and patient satisfaction was recorded.

Results

Out of the 60 eligible patients, 56 patients were enrolled in the study with male predominance 51 (9.1%). Enrollment at gabapentin, pregabalin and placebo groups was (19, 18 and 19 respectively). Post-operative patient satisfaction was better in the pregabalin group with value 8.1 ± 1.1 compared to 7.9 ± 1 in the gabapentin group, and 6.7 ± 1.2 in the placebo group (P < 0.001). The amount of post-operative morphine PCA was lowest in the pregabalin group 22.4 ± 6 versus 27.1 ± 5.1 in the gabapentin group; with the highest was in the placebo controlled group 31 ± 5.1 (p < 0.001). Ostoperative patient satisfaction and morphine PCA were comparable between treatment groups

Conclusions

Both pregabalin and gabapentin were effective for reduction of post CABG morphine consumption and had better patient satisfaction if given preemptively as a single dose preoperatively.