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Pregabalin for Acute Pain: A Review of the Clinical Effectiveness

Last updated: January 24, 2017
Project Number: RC0843-000
Product Line: Rapid Response
Research Type: Drug
Report Type: Summary with Critical Appraisal
Result type: Report

Question

  1. What is the clinical effectiveness of pregabalin for acute pain?
  2. What is the comparative effectiveness of concurrent pregabalin and opioid use versus opioids alone for the management of acute or post-operative pain?

Key Message

One randomized controlled trial (RCT) demonstrated that compared to opioids alone, a single pre-operative dose of pregabalin in combination with post-operative opioids significantly reduced post-operative opioid consumption, pain scores and use of breakthrough analgesia at 48 hours. A second RCT demonstrated that compared to placebo, pregabalin significantly reduced various symptom components of the neuropathic pain scale and procedural pain over four weeks in patients with severe burn injury. A third randomized controlled cross-over trial failed to demonstrate a significant reduction in pain scores when a single dose of pregabalin was compared to placebo in patients with acute pain secondary to herpes zoster. There was no significant increase in adverse effects associated with pregabalin in any of the studies. Overall, pregabalin may be a viable option for post-operative pain management as part of a multimodal approach. The evidence for pregabalin use in acute pain is weak and limited to pain secondary to acute burns. No evidence was found for the use of pregabalin in combination with opioids compared to opioids alone in acute non-surgical pain.