基于FAERS数据库的普瑞巴林不良事件信号挖掘与分析

目的 通过挖掘真实世界中与普瑞巴林关联的药物不良事件信号,为其临床安全合理用药提供参考。方法 调取美国食品药品监督管理局(FDA)不良事件报告系统(FAERS)中普瑞巴林2015年1月1日—2023年1月31日的数据,运用报告比值比法和贝叶斯可信区间递进神经网络法进行信号挖掘,分析其药物不良反应发生情况。结果 共得到药物不良事件信号288个,其中发生频次排在前5位的药物不良事件是全身性疾病及给药部位各种反应,精神疾病类,各类神经系统疾病,各类损伤、中毒及操作并发症,各种肌肉骨骼,以及结缔组织疾病;挖掘到9个未收录于说明书中的新发现可疑不良反应,尿尿素增高、颏麻木综合征、幻肢综合征、身高降低等。结论 普瑞巴林在真实世界中发生的常见不良反应应与说明书保持一致性,对于临床上部分新出现可疑的不良反应,在用药时应重点关注。     

普瑞巴林的合成工艺改进及还原副产物的分离鉴定

目的改进普瑞巴林的合成工艺并分离鉴定还原副产物。方法以亚磷酸三乙酯和氯乙酸乙酯为起始原料,经Arbuzov反应、Wittig-Horner反应、Michael加成、还原、拆分5步反应得到普瑞巴林。结果与结论目标化合物及还原副产物4-异丁基-2-吡咯烷酮经IR1、H-NMR、ESI-MS及元素分析确证,总收率为27.8%,改进后的工艺,反应步骤短,操作安全简便,有利于工业化生产。     

普瑞巴林对腰椎间盘突出微创术患者术后疼痛及血清TNF-α、IL-6水平影响

目的 探究普瑞巴林胶囊对腰椎间盘突出微创术患者术后疼痛及血清肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）水平的影响。方法 选取2014年1月-2018年1月于延安大学附属医院进行微创治疗的138例腰椎间盘突出患者为研究对象，按照随机数字表法将其分为对照组和实验组，每组各69例。对照组患者于麻醉实施2 h前服用塞来昔布胶囊0.4g，术后对照组患者每12 h服用一次塞来昔布胶囊进行镇痛，每次服用剂量为0.2 g；实验组患者麻醉前服用普瑞巴林胶囊200 mg，术后每12 h服用一次普瑞巴林胶囊进行镇痛，服用剂量为150 mg/次。比较两组患者静息痛及活动痛VAS评分、血清炎性因子水平和远期随访3个月内的神经性病理疼痛发生率。结果 术后，两组VAS评分均有所下降，同组治疗前后比较差异具有统计学意义（P<0.05），且实验组患者术后12、24、72 h静息痛及活动痛VAS评分均低于对照组，两组比较差异具有统计学意义（P<0.05）。术后72 h两组TNF-α、IL-6水平均有所下降，同组治疗前后比较差异具有统计学意义（P<0.05）；同时实验组血清因子水平显著低于对照组，两组比较差异具有统计学意义（P<0.05）。术后3个月随访示实验组神经性病理疼痛发生率低于对照组，两组比较差异有统计学意义（P<0.05）。结论 普瑞巴林胶囊能够有效缓解腰椎间盘突出微创术患者术后疼痛，同时降低其血清TNF-α、IL-6水平，且远期随访效果较好，值得进行临床推广使用。     

丁丙诺菲透皮贴联合普瑞巴林治疗老年带状疱疹后神经痛的临床观察

目的观察丁丙诺菲透皮贴联合普瑞巴林治疗老年带状疱疹后神经痛的临床效果。方法 60例老年带状疱疹后神经痛患者随机分为试验组和对照组。试验组:丁丙诺菲透皮贴联合普瑞巴林;对照组:单独应用口服普瑞巴林。治疗8周后记录两组患者用药前、用药后2周、4周、8周的疼痛评分(visual analogue scale,VAS)、睡眠评分、普瑞巴林日剂量及不良反应发生率。结果两组患者治疗后VAS评分明显低于治疗前(P<0.01),治疗后4周及8周试验组VAS评分明显低于对照组(P<0.05);用药治疗后两组患者睡眠质量明显改善(P<0.05);联合应用丁丙诺菲透皮贴后可明显减少试验组普瑞巴林的用量(P<0.05);联合应用丁丙诺菲透皮贴可以显著减少普瑞巴林相关不良反应头晕、嗜睡的发生率(P<0.05)。结论丁丙诺菲透皮贴联合普瑞巴林对老年带状疱疹后神经痛患者的临床效果优于单独应用普瑞巴林,不良反应较小。     

加巴喷丁治疗糖尿病周围神经痛的Meta分析

目的 评价加巴喷丁治疗糖尿病性周围神经痛的有效性和安全性.方法 采用循证医学的文献分析评价方法,计算机检索Cochrane图书馆系统评价数据库、Pubmed、中国学术期刊全文数据库、万方数据库、维普数据库等,采用RevMan5.2软件进行Meta分析.结果 纳入研究12项,共931例患者,Meta分析显示加巴喷丁反应有效率[OR=2.99,95%CI(1.72,5.20),P <0.000 1]及不良反应发生率[OR=4.05,95%CI(1.10,14.95),P=0.04]均高于安慰剂,加巴喷丁治疗效果高于卡马西平/奥卡西平[OR=3.60,95%CI(1.14,11.31),P=0.03]和维生素B₁₂,而不良反应则较卡马西平轻;加巴喷丁与度洛西汀、普瑞巴林比较,治疗效果相当,但度洛西汀[OR=2.06,95%CI(1.22,3.48),P=0.007]和普瑞巴林的不良反应较少.结论 加巴喷丁治疗糖尿病性周围神经痛效果显著,安全性较好.     

普瑞巴林对肺楔形切除术后急性疼痛影响的回顾性队列研究

目的 探讨普瑞巴林对肺楔形切除术后急性疼痛的治疗作用。方法 收集2018年至2020年进行肺癌楔形切除手术的患者,采用回顾性队列研究,根据是否使用普瑞巴林分为两组,普瑞巴林组和非普瑞巴林组。采用倾向性评分1∶1匹配筛选合适病例后,对普瑞巴林的疗效以及两组术后阿片类药物、非甾体类药物使用量进行统计分析。结果 本研究最终共纳入186例患者,每组各93例,与非普瑞巴林组相比,普瑞巴林组手术后24 h、48 h的NRS评分降低,差异有统计学意义(P<0.05);两组阿片类药物使用量差异无统计学意义(P>0.05);两组术后阿片类药物和非甾体类抗炎药物的总DDDs差异无统计学意义(P>0.05)。结论 术后1日2次口服75 mg普瑞巴林可以缓解肺楔形切除术后疼痛。     

高效液相色谱法测定普瑞巴林的溶出度

目的 本文建立了以高效液相色谱法测定普瑞巴林胶囊溶出度的方法 .方法 以盐酸溶液(9→1000)为溶出介质,色谱柱为Lichrospher-C18柱,流动相为甲醇-乙腈-20mM磷酸盐缓冲液(pH7.0)(350∶100∶550),流速为1.0mL·min-1.检测波长为210nm,以外标法进行定量分析.结果 普瑞巴林的浓度与峰面积在150.6～351.4μg·mL-1范围内呈线性关系,r=0.9991,平均回收率为97.0%(n=9),普瑞巴林胶囊在30min时的平均累积溶出率为95.1%.结论 普瑞巴林胶囊的溶出度好,本测定方法 的专属性与准确性较高,可用于普瑞巴林胶囊的质量控制.     

普瑞巴林在慢性疼痛治疗中的应用

普瑞巴林是新型γ-氨基丁酸(GABA)受体激动剂,可与中枢神经系统电压依赖性钙通道的Ⅰ型α2-δ亚基相结合,减少钙离子内流,从而减少兴奋性神经递质的释放,进而有效控制神经性疼痛.文中总结了近几年来普瑞巴林用于治疗慢性疼痛,尤其是慢性神经性疼痛的研究,证实该药可有效缓解疼痛、改善睡眠、提高生活质量.目前普瑞巴林的常用剂量为150～600 mg·d-1,分2次或3次口服,不良反应主要有头晕、嗜睡和共济失调.此外,文中还对普瑞巴林与加巴喷丁在药理学特性、作用机制及临床应用方面进行了比较.     

普瑞巴林联合氟哌噻吨美丽曲辛治疗脑卒中后丘脑痛的临床疗效及安全性评价

目的：探讨普瑞巴林联合氟哌噻吨美丽曲辛治疗脑卒中后丘脑痛的临床疗效及安全性。方法将108位脑卒中后丘脑痛患者随机分为普瑞巴林联合组、普瑞巴林组和加巴喷丁组,每组36例。其中普瑞巴林以150 mg／d为起始剂量应用,以后根据患者疗效及耐受性每3天1次增量,最终调整至最大剂量300 mg／d;氟哌噻吨美丽曲辛1片／d口服治疗;加巴喷丁以300 mg／d为起始剂量应用,以后根据患者疗效及耐受性,调整至最大剂量1800 mg／d。研究持续时间为8周,对所有患者在4个时间点（1、2、4、18周）进行疼痛数字评分（ NRS）和汉密尔顿抑郁量表评分（ HAMD）,并观察药物不良反应。结果与加巴喷丁组比较,普瑞巴林联合组各个时间点的NRS评分和HAMD评分均显著下降（ P ＜0厖．05）。与普瑞巴林组比较,普瑞巴林联合组各时间点的NRS评分均显著较低（ P ＜0．05）,第4周和第8周的HAMD评分显著较低（ P ＜0．05）。3组不良事件出生率比较差异无统计学意义（ P ＞0．05）。结论普瑞巴林联合氟哌噻吨美丽曲辛治疗脑卒中后丘脑痛疗效显著,安全性好,效果优于普瑞巴林及加巴喷丁单药。     

普瑞巴林对腰椎间盘突出症术后疼痛的影响

目的观察普瑞巴林用于腰椎间盘突出症术后镇痛的效果及安全性。方法择期行腰椎间盘突出症手术的患者72例,随机分为三组,每组24例。普瑞巴林组和塞来昔布组患者分别于麻醉前2 h口服普瑞巴林300 mg或塞来昔布400 mg,术后12 h开始口服普瑞巴林150 mg或塞来昔布200 mg,q12h;对照组在相应的时点给予维生素C。三组其余麻醉及给药方式相同,均以曲马多辅助镇痛。记录术后2、6、12、24、48 h患者的视觉模拟量表评分(VAS)及术后48 h内曲马多用量、不良反应发生率及患者满意率。结果术后各时间点普瑞巴林组和塞来昔布组静息痛和活动痛VAS均低于对照组(P<0.05),普瑞巴林组活动痛VAS低于塞来昔布组(P<0.05),静息痛VAS与塞来昔布组相似(P>0.05)。普瑞巴林组和塞来昔布组曲马多人均用量均低于对照组(P<0.05),两组间无显著差异(P>0.05)。术后48 h,对照组不良反应发生率33%,高于普瑞巴林组和塞来昔布组(12%和25%,P<0.05),均未见严重不良反应发生;普瑞巴林组满意率79%,高于塞来昔布组和对照组(67%和25%,P<0.05)。结论腰椎间盘突出症围手术期应用普瑞巴林镇痛效果良好且安全,患者满意率高。     

Effect of pregabalin on fear-based conditioned avoidance learning and spatial learning in a mouse model of scopolamine-induced amnesia

Objectives: Cognitive deficits are one of the frequent symptoms accompanying epilepsy or its treatment.

Methods: In this study, the effect on cognition of intraperitoneally administered antiepileptic drug, pregabalin (10?mg/kg), was investigated in scopolamine-induced memory-impaired mice in the passive avoidance task and Morris water maze task. The effect of scopolamine and pregabalin on animals’ locomotor activity was also studied.

Results: In the retention phase of the passive avoidance task, pregabalin reversed memory deficits induced by scopolamine (p?p?p?p?Discussion: In passive avoidance task, pregabalin reversed learning deficits induced by scopolamine. In the Morris water maze, pregabalin did not influence spatial learning deficits induced by scopolamine. These results are relevant for epileptic patients treated with pregabalin and those who use it for other therapeutic indications (anxiety, pain).     

氨酚曲马多联合普瑞巴林治疗癌性神经病理性疼痛的疗效观察

目的探究氨酚曲马多片联合普瑞巴林胶囊治疗癌性神经病理性疼痛的临床疗效。方法选取2015年4月—2017年4月郑州大学附属郑州中心医院收治的癌性神经病理性疼痛患者150例为研究对象,所有患者随机分为普瑞巴林组、氨酚曲马多组和联合治疗组,每组各50例。普瑞巴林组口服普瑞巴林胶囊,75 mg/次,2次/d;氨酚曲马多组口服氨酚曲马多片,100 mg/次,1次/d;联合治疗组口服普瑞巴林胶囊和氨酚曲马多片,用法同上。所有患者均连续治疗4周。观察两组的临床疗效,比较两组的疼痛数字(NRS)评分、生活质量(QOL)评分和睡眠质量(MOS)评分。结果治疗后,普瑞巴林组、氨酚曲马多组、联合治疗组疼痛总缓解率分别为62.00%、64.00%、82.00%,联合治疗组与普瑞巴林组、氨酚曲马多组比较差异具有统计学意义(P0.05)。治疗后,3组NRS评分均显著降低,同组治疗前后比较差异具有统计学意义(P0.05);且联合治疗组NRS评分明显低于普瑞巴林组、氨酚曲马多组,两组比较差异具有统计学意义(P0.05)。治疗后,3组QOL评分均显著降低,同组治疗前后比较差异具有统计学意义(P0.05);且联合治疗组QOL评分明显低于普瑞巴林组、氨酚曲马多组,两组比较差异具有统计学意义(P0.05)。治疗后,普瑞巴林组、联合治疗组睡眠干扰(SLPD)、睡眠量(SLPQ)评分显著降低,睡眠充足度(SLPA)评分显著升高,同组治疗前后比较差异具有统计学意义(P0.05);且联合治疗组这些观察指标的改善程度明显优于普瑞巴林组、氨酚曲马多组,3组比较差异具有统计学意义(P0.05)。结论氨酚曲马多片联合普瑞巴林胶囊治疗癌性神经病理性疼痛具有较好的临床疗效,可缓解患者癌性疼痛,改善患者生活质量和睡眠质量,安全性较好,具有一定的临床推广应用价值。     

Alternative method to improve the ethyl valerate yield using an immobilised Burkholderia cepacia lipase

Abstract

This study is focussed on a biocatalysing chemical synthesis in order to produce a green apple flavour (ethyl valerate) using an immobilised lipase from Burkholderia cepacia. A strategy to improve the lipase stability during the esterification is used. In order to increase the ethyl valerate efficiency, an alternative method using the buffer pH to dissolve the lipase into alginate is proposed. Parameters of the immobilised lipase such as pH, temperature, activation energy and stirring speed are evaluated. The optimal condition using the substrate concentration and the lipase loading is provided. After 5 recyclability cycles, the immobilised lipase reveals a decreasing ～25% in the ethyl valerate yield. An economical ester synthetising associated with the esterification efficiency is evidenced. This induces that a potential industrial application can be considered. This due to the demand for ethyl valerate in the flavour industry is required.     

Mucosal Uptake of Gabapentin (Neurontin) vs. Pregabalin in the Small Intestine

Purpose. To compare the mucosal membrane transport of gabapentin and pregabalin in animal small intestine. Methods. Uptake of the two drugs by brush-border membrane vesicles (BBMV) from rat and rabbit small intestine was studied as a function of temperature, uptake-medium sodium content, and intestinal region. Amino acid inhibition studies were conducted with pregabalin. Results. Gabapentin uptake by rat and rabbit jejunal BBMV was sodium independent, whereas pregabalin uptake was sodium dependent. Uptake of both drugs in rabbit small intestinal vesicles was greater at 25°C than at 4°C in the absence of sodium and an additional increase in uptake was observed for pregabalin at 25°C in the presence of sodium. Pregabalin uptake in rabbit duodenal, jejunal, and ileal BBMV was equivalent, whereas gabapentin uptake was greater in duodenal and ileal BBMV, compared with jejunal BBMV. Although inhibition is weak, a decrease in BBMV uptake of pregabalin is observed with coincubation of high concentrations of both neutral and basic amino acids. Conclusions. Amino acid carriers mediate the apical uptake of both drugs in the small intestine. Although gabapentin and pregabalin are structurally similar, their small intestinal mucosal uptake differs in sodium dependence and region dependence. Gabapentin uptake is likely mediated by system b^0,+, whereas pregabalin uptake is also mediated by B⁰ and/or B^0,+.     

Pregabalin for the treatment of fibromyalgia

Introduction: Fibromyalgia (FM) is the most common cause of chronic widespread body pain in humans. Co-morbidities include sleep disturbance, fatigue, impaired physical functioning, altered mood and negative effects on health-related quality of life. Pregabalin inhibits presynaptic release of pronociceptive neurotransmitters in the CNS; this likely underpins its therapeutic benefit in patients with FM.

Areas covered: This review addresses pregabalin pharmacokinetics, efficacy and adverse event (AE) profiles from randomized controlled trials and open-label extension studies in patients with FM. These effects are compared with those of the serotonin norepinephrine reuptake inhibitors, duloxetine and milnacipran that also have FDA approval for the treatment of fibromyalgia.

Expert opinion: At the approved dosages, oral pregabalin has at most a moderate therapeutic benefit above placebo with tolerable side-effects, in no more than 50% of patients with FM. Durability of clinically meaningful (≥ 30%) pain relief in pregabalin-responders has been demonstrated for at least 6-months, but longer-term studies are required as most patients have symptoms for decades. Exclusion of patients with common co-morbidities from the pregabalin RCTs in FM raises questions on the generalizability of the RCT findings to the typical patient seen in clinical practice and so additional investigation is required.     

Reports of gabapentin and pregabalin abuse,misuse, dependence,or overdose: An analysis of the Food And Drug Administration Adverse Events Reporting System (FAERS)

BackgroundReports of gabapentinoid (gabapentin and pregabalin) misuse have increased in recent years. Pharmacovigilance data from the Food and Drug Administration Adverse Event Reporting System (FAERS) provides a useful examination of adverse drug event (ADE) reporting for safety signal detection.ObjectiveThis study was conducted to analyze epidemiological information on the nature and extent of gabapentin/pregabalin abuse utilizing the FAERS database.MethodsA query was designed utilizing SafeRx, an indexed, searchable database of FAERS data from October 2012–December 2016. All-cause and abuse-related (including abuse/misuse/dependence/overdose events) ADE reports for gabapentin and pregabalin were isolated, as well as limited demographic data. The proportional reporting ratio (PRR) was calculated to compare signal detection.ResultsA total of 10,038 all-cause ADEs were reported to FAERS for gabapentin, including 576 (5.7%) abuse-related events. For pregabalin, 571 all-cause ADEs were identified, including 58 (10.2%) related to abuse. Compared to all-cause ADEs, those involved in abuse-related events were younger and more likely to be male. The PRR of pregabalin versus gabapentin abuse-related events was 1.77.ConclusionThough not traditionally thought of as drugs of abuse, over 600 cases of gabapentinoid abuse were reported in the time frame analyzed, prompting the need for further study and regulatory investigation.     

The efficacy of pregabalin in patients with moderate and severe pain due to diabetic peripheral neuropathy

Objective To compare the therapeutic response to pregabalin in patients with moderate or severe painful diabetic peripheral neuropathy (pDPN).

Research design and methods Data were pooled from 11 placebo-controlled trials to evaluate the efficacy of pregabalin flexible or fixed dose (150, 300 or 600?mg/day) in pDPN patients with mean baseline pain scores of ≥4 to <7 (moderate) or ≥7 to ≤10 (severe). Last observation carried forward imputation was used.

Study number/ClinicalTrials.gov identifier 1008-014/-, 1008-029/-, 1008-040/-, 1008-131/-, 1008-149/-, 1008-000-155/-, A0081030/NCT00156078, A0081060/NCT00159679, A0081071/NCT00143156, A0081081/NCT00301223, A0081163/NCT00553475.

Main outcome measures Pregabalin-mediated change in pain, pain-related sleep interference (PRSI) and patient global impression of change (PGIC) were compared versus placebo and between moderate and severe pain cohorts. Adverse events (AEs) were reported.

Results At baseline, 1816 patients had moderate pain (pregabalin, n?=?1189) and 1119 patients had severe pain (pregabalin, n?=?720). Pregabalin significantly reduced pain scores at endpoint compared with placebo when patients of all pain levels were combined (all doses; p?<?0.05). In the moderate and severe pain cohorts, pregabalin treatment (300, 600?mg/day or flexible) significantly reduced mean pain scores at endpoint compared with placebo (p?<?0.01). Pain reduction was greatest in patients with severe baseline pain compared with moderate baseline pain (pregabalin 300, 600?mg/day or flexible; p?<?0.0001). Pregabalin improved PRSI and PGIC in the moderate and severe cohorts compared with placebo. The greatest improvement in PRSI also occurred in the severe cohort. Treatment-emergent AEs, most commonly dizziness, somnolence and peripheral edema, occurred more frequently in patients treated with pregabalin compared with placebo.

Conclusions Pregabalin was effective in pDPN patients with both moderate and severe baseline pain. Patients with severe pain exhibited greater improvements in pain and PRSI than patients with moderate pain. Pain severity may, in part, predict therapeutic response to pregabalin.     

Transport of Pregabalin in Rat Intestine and Caco-2 Monolayers

Purpose. The purpose of this study was to determine if the intestinal transport of pregabalin (isobutyl --aminobutyric acid, isobutyl GAB A), a new anticonvulsant drug, was mediated by amino acid carriers with affinity for large neutral amino acids (LNAA). Methods. Pregabalin transport was studied in rat intestine and Caco-2 monolayers. An in vitro Ussing/diffusion chamber model and an in situ single-pass perfusion model were used to study rat intestinal transport. An in vitro diffusion chamber model was used to evaluate Caco-2 transport. Results. In rat ileum, pregabalin transport was saturable and inhibited by substrates of intestinal LNAA carriers including neurontin (gabapentin), phenylalanine, and proline. Weak substrates of intestinal LNAA carriers (-alanine, --aminobutyric acid, and methyl aminoisobutyric acid) did not significantly change pregabalin transport. In Caco-2 mono-layers that showed a high capacity for phenylalanine transport, pregabalin transport was concentration- and direction-independent and equivalent in magnitude to the paracellular marker, mannitol. The in vitro and in situ rat ileal permeabilities of the LNAA carrier-mediated compounds neurontin, pregabalin, and phenylalanine correlated well with the corresponding in vivo human oral absorption. Conclusions. The transport of pregabalin was mediated by LNAA carriers in rat ileum but not in Caco-2 monolayers. Caco-2 was not an appropriate model for evaluating the in vivo human oral absorption of pregabalin and neurontin.     

Synergistic interaction of pregabalin with the synthetic cannabinoid WIN 55,212-2 mesylate in the hot-plate test in mice: an isobolographic analysis

BackgroundThe aim of the study was to determine the type of interaction between pregabalin (a 3^rd-generation antiepileptic drug) and WIN 55,212-2 mesylate (WIN – a highly potent non-selective cannabinoid CB1 and CB2 receptor agonist) administered in combination at a fixed ratio of 1:1, in the acute thermal pain model (hot-plate test) in mice.MethodsLinear regression analysis was used to evaluate the dose-response relationships between logarithms of drug doses and their resultant maximum possible antinociceptive effects in the mouse hot-plate test. From linear equations, doses were calculated that increased the antinociceptive effect by 30% (ED₃₀ values) for pregabalin, WIN, and their combination. The type of interaction between pregabalin and WIN was assessed using the isobolographic analysis.ResultsResults indicated that both compounds produced a definite antinociceptive effect, and the experimentally-derived ED₃₀ values for pregabalin and WIN, when applied alone, were 29.4 mg/kg and 10.5 mg/kg, respectively. With isobolography, the experimentally derived ED_{30 mix} value for the fixed ratio combination of 1:1 was 5.7 mg/kg, and differed significantly from the theoretically calculated ED_{30 add} value of 19.95 mg/kg (p < 0.01), indicating synergistic interaction between pregabalin and WIN in the hot-plate test in mice.ConclusionsIsobolographic analysis demonstrated that the combination of WIN with pregabalin at a fixed ratio of 1:1 exerted synergistic interaction in the mouse model of acute thermal pain. If the results from this study could be adapted to clinical settings, the combination of WIN with pregabalin might be beneficial for pain relief in humans.     

Pregabalin for the treatment of postsurgical pain

Importance of the field: Multimodal postoperative pain management targeted at diminishing harmful outcomes should include pregabalin in cases that need opioid reduction and when the risk of developing chronic neuropathic postsurgical pain is present. Gabapentanoids have grown in importance due to their opioid-sparing effects. They may also contribute to the prevention of chronic postsurgical pain.

Areas covered in this review: We reviewed the literature regarding the use of gabapentanoids and their role in treatment modalities in acute postsurgical pain. Dosing, therapeutic efficacy, side effects, and their role within a multimodal regimen are discussed. Particular emphasis is placed on their ability to provide an opioid-sparing effect, as well as on their potential for inhibiting chronic neuropathic pain. A Pubmed search of pregabalin, gabapentin, acute pain, multimodal analgesia, chronic postsurgical pain, and neuropathic pain between 2000 and 2010 was done. Relevant articles – including randomized controlled trials, retrospective trials, case series, case reports, and review articles – were filtered to include those that relate to postsurgical pain.

What the reader will gain: Readers will gain an increased appreciation of the role of pregabalin in postsurgical pain in patients at risk of developing chronic pain.

Take home message: Pregabalin is a safe and effective medication that may decrease perioperative opioid use in patients with more acute neuropathic pain than acute inflammatory pain. When surgery involves more neuropathic-type acute pain there is growing evidence that pregabalin may decrease the incidence of chronic pain.