Study Design. Prospective, double-blind study, randomized control trial.
Objective. To evaluate and compare the analgesic efficacy, adverse effects, and clinical utility of gabapentin and pregabalin in postoperative pain management, long-term functional outcome, and quality of life in patients undergoing spinal surgery.
Summary of Background Data. Patient outcome after lumbar discectomy for radicular low back pain is variable and the benefit is inconsistent. The most common persistent symptoms are pain, motor deficit, and decreased functional status.
Methods. This study was conducted in 90 patients belonging to the 18 to 75 age group of either sex undergoing spinal surgery under general anesthesia. Group A received 300 mg of gabapentin, group B received 75 mg of pregabalin, whereas group C received placebo 1 dose 1 hour before surgery and 8 hourly for 7 days, thereafter. The outcome of postoperative static and dynamic pain and functional outcome was recorded using 3 questionnaires—visual analogue scale, Prolo functional and economic score, Oswestry Disability Index score from preoperative period to 3 months postoperatively.
Results. Among the 3 groups, subjects receiving pregabalin showed consistently reduced static and dynamic pain intensity and also required lesser amount of rescue drug throughout the postoperative period. There was statistically significant difference (P < 0.05) in the Prolo score and Oswestry Disability Index score at all time intervals between group B and group C. Although, significant difference in the functional outcome between group A and group B was seen at 3 months.
Conclusion. Preoperative pregabalin administration is associated with less pain intensity and improved functional outcomes 3 months after lumbar discectomy followed by gabapentin and then placebo.
Level of Evidence: 2
Perioperative administration of gabapentinoid may prove beneficial to patients undergoing lumbar discectomy in terms of pain and 3-month functional outcome. As compared with gabapentin, pregabalin had more favorable long-term effects.
Departments of *Anesthesiology; and
†Neurosurgery, Himalayan Institute of Medical Sciences, HIHT University, Swami Ram Nagar, Dehradun, India.
Address correspondence and reprint requests to Parul Jindal, MD, Department of Anesthesiology, Himalayan Institute of Medical Sciences, HIHT University, Swami Ram Nagar, Dehradun, India; E-mail: firstname.lastname@example.org
Acknowledgment date: August 6, 2013. First revision date: November 8, 2013. Second revision date: December 3, 2013. Acceptance date: December 16, 2013.
The device(s)/drug(s) is/are FDA-approved or approved by corresponding national agency for this indication.
No funds were received in support of this work.
No relevant financial activities outside the submitted work.