Multimodal pain management strategies, including pregabalin (PGB), are effective in reducing pain and opioid use after many types of surgeries. A single-center, retrospective study determined if a single pre-operative dose of PGB can reduce opioid requirements and postoperative pain after orthotopic liver transplantation (OLT). Outcomes were the mean morphine milligram equivalents used, the proportion of patients reporting no pain, and the maximum level of pain documented within the first 24h and in the 24-72h following OLT. 

Forty-four patients were given PGB while 57 were given standard of care. Both groups had similar baseline demographics. Patients who received PGB needed 70% and 54% fewer opioids within the first 24h and following 24-72h post-OLT, respectively. In the first 24h post-OLT, the PGB group had more patients with no documented pain, and fewer with severe pain, however, these were not significant. The majority of the participants in the PGB group reported a maximum of mild pain. 

This study showed that a single dose of pre-operative PGB can significantly reduce opioid use in the first 72 h after OLT. Larger studies are warranted to determine the safety and efficacy of PGB in this setting.

This study showed that a single dose of pre-operative PGB can significantly reduce opioid use in the first 72 h after OLT. Larger studies are warranted to determine the safety and efficacy of PGB in this setting.

Knorr JP, Barlow A, Reinaker TS, Zaki RF. A single dose of pre-operative pregabalin reduces post-operative opioid use after orthotopic liver transplantation. The Journal of Clinical and translational research. 2021;35(7):e14319. https://doi.org/10.1111/ctr.14319