The Effect Of Pregabalin On Acute Pain After Gynecological Surgery:a Meta-analysis

Objective: This meta-analysis is aimed to evaluate the effects of administration of pregabalin for postoperative pain management after gynecology surgery.Methods: A comprehensive literature search was conducted in three electronic databases including Pub Med,Embase,The Cochrane Library from their inception to January 2018 by computer,to identify the clinical trials that reported the effects of pregabalin on patients undergoing gynecological surgery.According to the Cochrane Reviewer's Handbook quality of the internalized articles were valuated.Using the Meta-analysis app Review Manager 5.3 for data analysis.Results: Eleven trails with 801 patients(pregabalin group = 448,control group = 353)fulfilled the eligibility criteria and were included in the meta-analysis.For non-laparoscopic surgery,pain scores at rest and on movement showed a statistically significant pain relief effect of pregabalin at 2h[at rest: MD(95% CI)=-1.02(-1.28,-0.76),P< 0.00001;on movement: MD(95% CI)=-0.61(-0.90,-0.33),P< 0.0001] and at 24h[at rest: MD(95% CI)=-0.29(-0.52,-0.05),P= 0.02;on movement: MD(95% CI)=-0.36(-0.66,-0.05),P= 0.02].Compared to placebo,pregabalin was associated with reduction in analgesic consumption at 2h [MD(95% CI)=-2.37(-3.01,-1.73),P< 0.00001],but the analgesic consumption at 24 h showed a significant heterogeneity which maybe resulted from different analgesic protocol.So only a general statistical description was taken.The occurrence of PONV was reduced in the pregabalin groups [RR(95% CI)= 0.60(0.42,0.86),P= 0.006] at the cost of increasing the risk of dizziness [RR(95% CI)= 1.58(1.21,2.08),P= 0.0009].Conclusion: Preoperative use of pregabalin is associated with the reduction of pain scores,analgesic consumption and the risk of PONV after gynecological surgery at the cost of increasing the risk of dizziness.