PRE-EMPTIVE ANALGESIA WITH PREGABALIN IN ELECTIVE LOWER LIMB ORTHOPAEDIC SURGERIES: A RANDOMIZED CONTROLLED TRIAL

Background: Postoperative pain in orthopaedic surgeries, particularly lower limb procedures, is severe and can delay rehabilitation. Pre-emptive analgesia aims to prevent central sensitization by administering analgesics before surgical injury. Objective: To evaluate the efficacy of pre-emptive pregabalin in reducing postoperative pain and opioid consumption in elective lower limb orthopaedic surgeries. Methods: A randomized, double-blind, placebo-controlled trial enrolled 60 patients undergoing elective lower limb orthopaedic surgeries. Patients received pregabalin (150 mg) or placebo one hour before surgery. Primary outcome was postoperative pain score (Visual Analog Scale, VAS) at 24 hours; secondary outcomes included opioid consumption and adverseeffects. Results:ThetimetofirstepiduraltopupforPregabalingroupis11.2±5.3hourswhen compared to 4.67±5.3 hours for control group (p<0.05). The total number of top upfor pregabalin group is 0.96±0.41 when compared to control group 1.7±0.7 (p<0.05). The total number of rescue morphine for pregabalin group is 0.47±0.6 whencompared to control group 1.57 ± 0.67 (p< 0.05). Conclusion: Pre-emptive pregabalin reduces postoperative pain and opioid requirements in lower limb orthopaedic surgeries, supporting its use in multimodal analgesia.