1 / 14

Perioperative Pregabalin Reduces Neuropathic Pain at 6 months after TKA

Perioperative Pregabalin Reduces Neuropathic Pain at 6 months after TKA. Asokumar Buvanendran, MD Associate Professor Director of Orthopedic Anesthesia Department of Anesthesiology Rush University Medical College Chicago, IL. Co-Investigators: J. Kroin, PhD

mairwen
Download Presentation

Perioperative Pregabalin Reduces Neuropathic Pain at 6 months after TKA

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Perioperative Pregabalin Reduces Neuropathic Pain at 6 months after TKA Asokumar Buvanendran, MD Associate Professor Director of Orthopedic Anesthesia Department of Anesthesiology Rush University Medical College Chicago, IL

  2. Co-Investigators: J. Kroin, PhD C. Dellavalle, MD (orthopedic surgery) M. Kari, MD M. Moric, PhD K. Tuman, MD Medical school grant from Pfizer

  3. Mechanism of Analgesia • Gabapentin and Pregabalin bind to the alpha-2-delta sub-unit of the N-type voltage gated calcium channel • Same mechanism of action whether it is neuropathic pain or inflammatory pain (post-surgical) • This binding results in ↓ release of • Substance P, Calcitonin Gene-related peptide • Glutamate • It has been approved for Neuropathic pain conditions and recently for Fibromyalgia

  4. Chronic Neuropathic Pain From Orthopedic Surgery

  5. Consequence of Orthopedic Surgery: Chronic Pain Syndromes Knee Scope Post TKR

  6. RCT: Study Design (Level 1) • 240 Patients randomized into 2 groups: • Preop pregabalin 300 mg + Postop 150 mg BID for 10 days and then 75 mg BID and titrated to 50 mg and stopped on day #14 • Preop Placebo + Postop Placebo • Standard surgery and anesthesia • Anesthesia: • Combined spinal epidural

  7. RCT: Study Design (Level 1) • Outcomes: • Chronic Neuropathic pain at: • Telephone Interview of these patients • 1, 3 and 6 moths postop • Follow-up data: • 113 patients for Pregabalin • 115 patients for Placebo

  8. S-LANSS Pain Score:  12 points is neuropathic pain

  9. Demographics

  10. Neuropathic Pain from TKA * *

  11. Allodynia or Hyperalgesia of Knee * *

  12. Knee Injury Osteoarthritis Outcome Score (KOOS) • In patients with neuropathic pain the KOOS at 6 months: • Neuropathic pain: 49.0 16.2 (placebo pat) • No Neuropathic pain: 25.7  7.8 (placebo pat) • No Neuropathic pain: 12.4  5.5 (pregabalin pat)

  13. Conclusion • The perioperative administration of pregabalin for TKA patients can lead to: • ↓ incidence of Chronic Neuropathic pain • ↑ Quality of life for patients that developed chronic pain

More Related