Pregabalin does not reduce postoperative pain after outpatient ACL surgery: A case-control study

Area of Science:

• Orthopedic Surgery
• Pain Management
• Pharmacology

Background:

• Pregabalin was previously recognized for its efficacy in managing early postoperative pain following anterior cruciate ligament (ACL) repair.
• Regulatory changes in France mandated secure prescriptions for pregabalin, impacting its availability as a postoperative analgesic.
• The French ACL Study (FAST) cohort experienced a discontinuation of pregabalin treatment due to these new regulations.

Purpose of the Study:

• To assess the impact of pregabalin discontinuation on early postoperative pain after ACL reconstruction.
• To compare pain levels in patients who received pregabalin versus those who did not, following regulatory changes.

Main Methods:

• A case-control study included 584 patients undergoing primary isolated ACL reconstruction from the FAST cohort.
• Patients were divided into two groups: those operated before June 1, 2021 (received pregabalin) and those operated after (did not receive pregabalin).
• Pain was measured using a visual analog scale (VAS) on postoperative days D0 (evening and night), D1, D2, and D3, with matching for age, sex, and preoperative scores.

Main Results:

• Patients not receiving pregabalin reported significantly higher pain scores on the night of D0 (5.21 vs 5.68, p=.048).
• No statistically significant differences in pain levels were observed between the groups at rest on the evening of D0, or on D1, D2, and D3.

Conclusions:

• Pregabalin does not appear to offer a clinically significant reduction in early postoperative pain for outpatient arthroscopic ACL reconstruction.
• The study suggests that alternative pain management strategies may be sufficient following ACL repair, considering the observed pain levels without pregabalin.