Jülide ERGİL, Savaş ALTINSOY, Fatma KAVAK AKELMA, İlkay Baran AKKUŞ, Derya ÖZKAN

The effects of pregabalin and adductor canal block on postoperative pain in arthroscopic anterior cruciate ligament reconstruction

Background/aim: To determine the effectiveness of pregabalin and adductor canal block on opioid consumption, postoperative pain,and fast-tracking.Materials and methods: A total of 51 American Society of Anaesthesiologists (ASA) classification I–II patients aged 18–70 years whowere scheduled to undergo elective anterior cruciate ligament reconstruction were included in the study. Patients were randomized intogroups P, A, and C. Patients in group P (n = 16), received 150 mg of preoperative oral pregabalin, patients in group A (n = 17) receivedpostoperative adductor canal blockade, and patients in group C (n = 18) received neither adductor canal block nor pregabalin. Surgerieswere performed under spinal anaesthesia with hyperbaric bupivacaine following monitorization. Demographic data along with blockfeatures, hemodynamic data, mean opioid consumption, numerical rating scale score, White’s fast-track score, and postoperative adverseeffects were recorded.Results: Fifty-seven patients were enrolled in the study, and 6 patients were excluded from the study; the data of 51 patients wereincluded in the final analyses. Demographic characteristics and hemodynamic data were similar between the 3groups. Postoperativeopioid consumption was significantly lower in groups A and P compared with group C (group P = 178.75 mg, group C = 318.61 mg,group A = 236.47 mg; P < 0.05). The regression of sensory block was significantly slower in group P (P < 0.05). The first analgesicrequirement was earlier in group C than in groups P and A (P < 0.05). Patients in group P had higher fast-track scores at 8 h and 12 hcompared with group C (P < 0.05); however, group A fast-track scores were similar to those of the other 2groups (P > 0.05). The rate ofpostoperative adverse effects was similar between the groups (P > 0.05).Conclusion: Preoperative pregabalin (150 mg) reduced postoperative opioid consumption as much as adductor canal block in patientsundergoing anterior cruciate ligament reconstruction. The first analgesic requirement was earlier in group C than in groups P and A. Inaddition, pregabalin can prolong the duration of spinal sensory block and shorten the time required to achieve high fast-tracking scores.We recommend the use of both methods as a part of multimodal analgesia.

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