Comparison Between Oxycodone and Pregabalin as Preemptive Analgesia for Postoperative Pain Control: A Randomized Controlled Trial

Preemptive analgesia is an intervention that provides analgesia preoperatively to reduce postoperative pain. Several medications have been studied as adjuvant therapy to general anesthesia, such as Pregabalin and oxycodone. However, only some studies have compared two options at the same time. Hence, the study aimed to assess the effectiveness of a single oral preemptive dose of Pregabalin versus oxycodone as preemptive analgesia on the short-term postoperative pain score. This three-armed, double-blinded, randomized controlled trial (RCT) was conducted from August 2021 to July 2022 in Nablus-Westbank-Palestine at the An-Najah National University Hospital (NNUH) surgery department. Patients undergoing Laparoscopic Cholecystectomy, Submucosal Resection, Breast Lumpectomy, or Median Laparotomy were recruited if they met inclusion criteria and were randomized to one of three arms. The medications were given 30 minutes before the induction of general anesthesia. Pain score, sedation score, vital signs, side effects, time to first use of rescue analgesia, total analgesic consumption, time to first use of antiemetic and total antiemetic consumption were reported 30 minutes preoperatively and at 0, 1, 4, and 8 hours postoperatively. A total of 168 patients were randomized to the control group, i.e., multivitamins group (n=56), Oxycodone group (n=55), or Pregabalin group (n=57). At 0 hours and 1 hour postoperatively, the mean pain score was the lowest in the pregabalin group and the highest in the placebo group. At 4 hours postoperatively, the mean pain score was the lowest in the placebo group and the highest in the pregabalin group. At 8 hours postoperatively, the mean pain score was the lowest in the pregabalin group and the highest in the oxycodone group. No significant changes in vital signs were recorded between the different groups. However, preemptive use of Oxycodone or Pregabalin, compared to placebo, did not significantly reduce postoperative pain levels or opioid consumption. In conclusion, oxycodone and Pregabalin as preemptive analgesia do not reduce early postoperative pain levels and/or opioid consumption, but they are safe options.