A recent study reviewed the literature to provide a comprehensive understanding of the preemptive effects of oral pregabalin in managing perioperative pain during lower limb orthopedic surgery.

It searched three electronic databases for randomized controlled trials comparing the results of preoperative pregabalin and placebo in patients undergoing lower limb orthopedic surgery. The study included twenty-one randomized controlled trials.

The pregabalin group showed significantly less -

• Cumulative opioid requirement within 24 and 48 h postoperatively 
• Pooled static pain intensity at all times within the first day
• Lower dynamic pain intensity at 48 h 
• Incidence of nausea

then in the placebo group. 

Meanwhile, pregabalin also showed an association with a higher incidence of dizziness and sedation. Subgroup analyses showed no difference between subgroups stratified by dosing regimen or pregabalin dose regarding opioid consumption, pain intensity, and incidence of complications.

This meta-analysis supports using pregabalin preoperatively in patients undergoing lower limb orthopedic surgery. However, it was concerned about dizziness and sedation caused by the process. Further, it describes no evidence to support the continued use of pregabalin postoperatively or using it more than 150 mg/day.

J Orthop Surg Res.2022; 17. https://doi.org/10.1186/s13018-022-03101-9