Oral pregabalin for acute pain relief after cervicofacial surgery: a systematic review

Post-operative pain is usually predictable and self-limiting. Pregabalin was investigated as coadjuvant in the multimodal treatment of postoperative analgesia. Numerous studies on the effectiveness of post-surgical oral Pregabalin have yielded highly contradictory results, and no consensus has been established on the optimal dose regimen. Therefore in this review, the authors suggested that oral Pregabalin appears to significantly alleviate post-operative pain and reduce rescue analgesia consumption, with no severe adverse effects.

This systematic review intended to unify the criteria on the Pregabalin efficacy to manage acute post-operative pain following cervicofacial surgery, to demonstrate the most effective dose regimens, and to assess its impact on rescue medicine utilization and its relationship with adverse events.  

The data for the analysis were searched from Web of Science, Cochrane databases, Medline, Scopus, and PubMed in any language published from January 2000 to September 2016. A question “Is oral Pregabalin effective and safe for the relief of acute pain after cervicofacial surgery?” was posted in accordance with PRISMA guidelines. The critical reading of the literature used a list of questions developed using CASPe Network, applying the Jadad scale for determination of the trials' methodological quality.

A total of eleven randomized controlled clinical trials were chosen. All trials exhibited a score ≥ three that considered as Ib evidence level and high quality. A reduction in pain and the need for rescue analgesia consumption was seen with administration of a single oral dose of 75-mg Pregabalin before or following cervicofacial surgery. Although the statistical significance of these findings is larger with a single dose of 150-mg Pregabalin, either before or following the surgery.

Oral Pregabalin considerably reduces the rescue analgesia consumption and postoperative pain without any adverse events. Although, the most effective administration regimen and ideal dose remain controversial problems that require to be solved in further high-quality clinical studies.