Pregabalin as a co-analgesic in patients undergoing laparoscopic sleeve gastrectomy: a double-blind, randomized, prospective clinical trial

Obese patients undergoing bariatric surgery are particularly susceptible to increased postoperative pain and opioid-related adverse effects. Enhancing patient safety and comfort may include the reduction of opioid requirements by the use of co-analgesics such as pregabalin. The aim of our study was to evaluate its safety and efficacy in patients undergoing laparoscopic sleeve gastrectomy (LSG). This double-blind, randomized controlled trial involved 90 patients who were assigned to receive either pre-operative pregabalin 150 mg or a placebo. The primary outcome was total oxycodone consumption within the first 24 h. We also assessed pain scores, incidence of nausea and vomiting, pregabalin-related side effects, hemodynamic parameters, and recovery at predefined time points. The pregabalin group had a similar total oxycodone consumption compared to the placebo. Concerning pain assessment, the study group had a lower score at the 6th hour, 2.16 vs. 2.64 (p = 0.047). No differences were found in the other outcomes. Pre-emptive 150 mg pregabalin before LSG was well tolerated, yet did not significantly reduce total oxycodone consumption. Moreover, the observed differences between groups at specific time points do not support the routine use of pregabalin until further research demonstrates clinically significant benefits.