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

BACKGROUND: 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. MATERIALS AND METHODS: 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. RESULTS: 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). CONCLUSIONS: 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.