Effect of pregabalin and dexamethasone addition to multimodal analgesia on postoperative analgesia following rhinoplasty surgery

We investigated the effect of a combination of pregabalin and dexamethasone, when used as part of a multimodal analgesic regimen, on pain control after rhinoplasty operations. Sixty patients were enrolled in this study. They were randomly assigned into three groups: Group C (placebo + placebo), Group P (pregabalin + placebo), and Group PD (pregabalin + dexamethasone). Patients received either pregabalin 300 mg orally 1 h before surgery, dexamethasone 8 mg intravenously during induction, or placebo according to their allocation. Postoperative pain was treated with intravenous patient-controlled analgesia (tramadol, 20-mg bolus dose, 45-min lockout time). The numeric rating scale (NRS), side effects, and consumption of tramadol, pethidine, and ondansetron were assessed. The median NRS scores at 0, 1, and 6 h after surgery were significantly higher in Group C than in Group PD (p < 0.001 for all). The 24-h consumption of tramadol and pethidine was significantly reduced in Groups P and PD compared to Group C (p < 0.01 and p < 0.01). The total tramadol consumption was decreased by 54.5 % in Group P and 81.9 % in Group PD compared to Group C (p < 0.001 for both). The incidence of nausea was higher in Group C than in Groups P and PD between the postoperative 0-2 and 0-24-h periods (p < 0.05 for both). The frequency of blurred vision was significantly higher in Groups P and PD than in Group C within the 0-24-h period (p < 0.05 for both). We found that the addition of a single dose of pregabalin and dexamethasone to multimodal analgesia in rhinoplasty surgeries provided efficient analgesia and thus decreased opioid consumption. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.