Multimodal perioperative pain management is crucial in enhancing recovery after surgery programs. The present study investigated the analgesic efficacy of the preoperative combination of 2 nonopioid drugs, oral pregabalin, and intravenous magnesium sulfate, in patients scheduled for posterolateral lumbar spinal fusion.

The study included 104 patients. It randomized them to receive: magnesium sulfate with pregabalin (MP), magnesium sulfate with oral placebo (M), 0.9% saline with oral pregabalin (P), and 0.9% saline with oral placebo (C); and administered them 1 hour preoperatively. The study looked for cumulative morphine consumption on postoperative day 1 and visual analog scale scores for leg pain (at rest and with movement) and postoperative nausea and vomiting (PONV) in the first 48 hours after surgery.

It found lower Cumulative morphine consumption on a postoperative day 1 in group MP compared with group M, group P, or group C. Multiple linear regression showed a significant association between group MP and cumulative morphine consumption. Furthermore, the study also found lower Visual analog scale scores for leg pain at rest and with movement in group MP compared with other groups; and the lowest incidence of PONV in group MP.

This study shows that the preoperative administration of oral pregabalin and intravenous magnesium sulfate causes reduced morphine consumption and greater analgesic effect than each drug individually or placebo in patients undergoing posterolateral lumbar spinal fusion.

Journal of Neurosurgical Anesthesiology. 2022;10(1097). doi: 10.1097/ANA.0000000000000893