Vol. 6, Issue 3 (2020)

Background and Objective: Total hip arthroplasty (THA) is associated with significant postoperative pain, often requiring high doses of opioids, which carry risks of adverse effects. Preemptive analgesia with pregabalin, a gabapentinoid with antihyperalgesic properties, may reduce postoperative pain and opioid consumption. This study aimed to evaluate the efficacy of preemptive pregabalin in decreasing postoperative pain intensity and opioid requirements in patients undergoing THA.

Material and Methods: This prospective, double-blind, randomized controlled trial included 60 patients aged 40-75 years undergoing elective unilateral total hip arthroplasty under spinal anesthesia. This study was conducted at the department of anaesthesia, Dhanlakshmi Srinivasan Medical College and Hospital, Perambular, Tamil Nadu, India from June 2019 to May 2020. Patients were randomly assigned into two groups (n=30 each). Postoperative pain was assessed using the Visual Analog Scale (VAS) at rest and during movement at 2, 6, 12, and 24 hours. Total opioid consumption (intravenous morphine equivalents) over 24 hours, time to first analgesic request, and incidence of side effects (dizziness, sedation, nausea, vomiting) were recorded.

Results: VAS scores at rest and on movement were significantly lower in Group P at all time points (p < 0.05). The mean 24-hour opioid consumption was significantly reduced in the pregabalin group (18.4 ± 5.6 mg) compared to the control group (28.7 ± 6.2 mg, p < 0.001). Time to first analgesic request was longer in Group P (4.8 ± 1.3 hours) than in Group C (2.6 ± 1.0 hours, p < 0.001). The incidence of dizziness and mild sedation was higher in Group P, but not statistically significant. Nausea and vomiting were less frequent in the pregabalin group.

Conclusion: Preemptive administration of 150 mg pregabalin effectively reduces postoperative pain intensity and opioid consumption in patients undergoing total hip arthroplasty without a significant increase in adverse effects. Pregabalin may be considered a useful adjunct in multimodal analgesia for enhanced recovery after hip arthroplasty.