Influence of pregabalin on post-operative pain after laparoscopic cholecystectomy: A meta-analysis of randomised...

Pregabalin may have some potential in reducing post-operative pain after laparoscopic cholecystectomy. However, the results remain controversial. We conduct a systematic review and meta-analysis to explore the influence of pregabalin on post-operative pain after laparoscopic cholecystectomy.

PubMed, Embase, Web of science, EBSCO and Cochrane Library databases have been systematically searched. Randomised controlled trials (RCTs) assessing the effect of pregabalin versus placebo on post-operative pain after laparoscopic cholecystectomy are included. The primary outcomes are pain scores at 8-12 h and 20-24 h. Secondary outcomes include sedation score, intraoperative fentanyl requirement, post-operative analgesic requirement, operative duration, post-operative nausea and vomiting, as well as respiratory depression. This meta-analysis is performed using the random-effect model.

Eight RCTs involving 528 patients were included in the meta-analysis. Overall, compared with control intervention after laparoscopic cholecystectomy, pregabalin treatment is found to significantly reduce pain scores at 20-24 h (Standard Mean difference [Std. MD] = -0.46; 95% confidence interval [CI] = -0.82--0.10), and post-operative analgesic requirement (Std. MD = -2.64; 95% CI = -3.94--1.33), but cannot substantially decrease pain scores at 8-12 h (Std. MD = -0.71; 95% CI = -1.70-0.27). In addition, pregabalin results in improved sedation score (Std. MD = 0.92; 95% CI = 0.55-1.29), but has no remarkable influence on intraoperative fentanyl requirement (Std. MD = 0.04; 95% CI = -0.30-0.39), operative duration (Std. MD = 0.34; 95% CI = -0.10-0.77), post-operative nausea and vomiting (Std. MD = 0.79; 95% CI = 0.59-1.11) as well as respiratory depression (Std. MD = 0.71; 95% CI = 0.17-3.02).

Compared to control intervention after laparoscopic cholecystectomy, pregabalin treatment can significantly decrease pain scores at 20-24 h and post-operative analgesic requirement, with no increase in adverse events.