Uso de pregabalina oral como analgesia preemptiva em histerectomia abdominal: avaliação da dor pós-operatória em um ensaio clinico randomizado

Abstract

Background. Postoperative pain is one of the main negative symptoms resulting from surgery. Thus, the use of new methods to control postoperative pain is recommended and multimodal analgesia, an opioid-sparing strategies, has been widely used by several researchers. Pregabalin is already well established in neuropathic pain, but in the surgical context for postoperative analgesia its use is still controversial. The aim of the present study was to analyze the effect of pregabalin on postoperative analgesia in patients undergoing abdominal hysterectomy. Methods. This is a randomized, double-blind, placebo controlled clinical trial in which female patients undergoing abdominal hysterectomy surgery were randomized to use pregabalin (Group P1), 300 mg orally 2 hours before surgery, or identical placebo tablets (Group P0). The main outcome is to evaluate the postoperative pain index using the visual analog scale (VAS) and the McGill pain questionnaire, secondary outcomes include opioid consumption and the presence of adverse effects. A value of p <0.05 was used to reject the type I error. Results. Fifty-five patients were randomized between groups. Patients in the P1 group had lower pain rates, both at rest and active movement, using the EVA scale when compared with the P0 group (p <0.001). In the McGill questionnaire, patients in the P1 group also had lower pain rates (12 x 28.5) with p < 0.001. There was approximately twice the consumption of opioids among patients in the P0 group (p <0.001). Regarding side effects, the dizziness was more frequent in the P1 group compared with P0 group (p = 0.01). Conclusion. The results of the present study suggest that pregabalin is an important adjuvant drug in the treatment of postoperative pain in patients undergoing abdominal hysterectomy surgery.