Pregabalin to Improve Postoperative Recovery After Bariatric Surgery: A Prospective, Randomized, Double-Blinded, Placebo-Controlled Study


Marcelo J. Martins,MD,* Caroline Paiva Matos Oliveira Martins, MD, Lucas J. Castro-Alves, MD,Gabriel Nascimento Jesus, Guilherme Oliveira Campos,MD, Breno Barbosa Cerqueira Sacramento, Leonardo Ferrari Borges, MD, Carlos Augusto Bastos Mello,MD* Rodrigo Leal Alves,MD,*Norma Sueli Pinheiro Módolo,MD, MSCI,

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BACKGROUND: Obesity is a chronic disease characterized by excessive accumulation of body fat. Due to the associated risks, it has been considered a major public health problem in developed countries. Bariatric surgery (open gastroplasty) has been used as an important strategy to treat this condition in developing countries, especially when associated with other comorbidities. Postoperative pain, however, is a frequent problem in the postoperative management of these patients. Pregabalin is a structural analogue of the gamma-aminobutyric acid neurotransmitter (GABA) that binds to the alpha-2-subunit of the voltage-dependent calcium channel, blocking the development of hyperalgesia and central pain sensitization. The main objective of the current investigation was to evaluate the effect of perioperative pregabalin versus placebo on postoperative quality of recovery in patients undergoing bariatric surgery. 

METHODS: The study was a prospective, randomized, placebo-controlled, double-blinded trial. After ethics committee approval, 80 healthy patients eligible for open gastroplasty under general anesthesia were recruited. Eighty Patients undergoing abdominal gastroplasty were randomized to receive pregabalin, group 1 (75 mg orally 1 hour before surgery) or an identical placebo pill, group 2. The primary outcome was the quality of recovery-40 score at 24 hours. Secondary outcomes included opioid consumption and postoperative pain scores. A P value <0.05 was used to reject type I error.
RESULTS: Eighty patients were recruited, and 60 completed the study. The median in global recovery scores (quality of recovery-40) at 24 hours after surgery in pregabalin group was 185 (176-191) x 184 (174-192) in placebo group   (P = 0.95). Total opioid consumption in the 24 hours did not present a statistically significant difference between the groups (P = 0,43). In addition, nausea, vomiting, and time to postanesthesia care unit discharge were not significantly reduced in the pregabalin group compared with placebo.
CONCLUSIONS: There were no significant differences between pregabalin and placebo with respect to our primary outcome, the quality of recovery-40 score at 24 hours in this specific population of study. Further studies are required to determine the potential pain-reducing benefit of pregabalin in the postoperative setting.

Pregabalin for improving the quality of anesthesia recovery in bariatric surgery: randomized, double-blind, placebo-controlled clinical trial