EFIKASNOST PREOPERATIVNOG PREGABALINA KOD AKUTNOG BOLA NAKON TORAKOTOMIJE

Abstract

Introduction. Acute post-thoracotomy pain remains a significant clinical challenge, potentially impairing recovery, increasing opioid consumption, and contributing to the development of chronic post-thoracotomy pain. Pregabalin is increasingly incorporated into multimodal perioperative analgesic protocols; however, the optimal timing of its administration remains uncertain.

Material and Methods. This prospective, randomized, double-blind study included 40 patients undergoing elective thoracotomy for lung surgery. Patients were randomly allocated using a sealed-envelope method into two groups. Group A received pregabalin 150 mg orally the evening before surgery and 2 hours preoperatively. Group B received pregabalin 75 mg orally the evening before surgery and 2 hours preoperatively, followed by an additional 150 mg postoperative dose on the day of surgery. Postoperative pain intensity was assessed using the Numerical Rating Scale over 48 hours. Total opioid consumption, sedation scores, and adverse effects were also recorded.

Results. Demographic and perioperative characteristics were comparable between groups. During the first 24 postoperative hours, pain scores and cumulative opioid consumption did not differ significantly. On postoperative day one, Group B demon strated significantly lower pain scores at 36 hours (p = 0.035) and borderline statistical significance at 48 hours (p = 0.061). There were no statistically significant differences in total opioid requirements, sedation scores, or incidence of adverse effects between groups. Conclusion. Perioperative pregabalin administration including an additional postoperative dose provides superior analgesia during the first postoperative day compared with preoperative administration alone, without increasing opioid consumption or sedation. These findings suggest that dosing timing plays an important role in optimizing acute post-thoracotomy pain management.