Pregabalina como atenuador da dor pós-operatória aguda e crônica em mastectomias: estudo duplamente encoberto e randomizado

Abstract

Chronic post-operative pain (DCPO) is a possible consequence of the surgical act, and occurs after many different procedures. There is a high prevalence of it on patients submitted to mastectomy, both partial and total, with negative consequences to their quality of life. Many risk factors were associated, although its development mecanism is not entirely elucidated yet. A multimodal approach has been preconized for the optimization of the treatment, which includes opting for minimally invasive surgical techniques or with nerve preservation and the use of adjuvant drugs like gabapentinoids, aiming reduction of opioids dosage and rediction of DCPO. The present study evaluated the effect of pregabaline on the reduction of post-operative pain and prevention of chronic post-operative pain on mastectomies, compared to a placebo control group. The patients were randomly allocated into two groups. The first (Group Pregabaline) received 150mg of pregabaline orally starting the night before the surgery and continued for 14 days; the second (Group Placebo) received similar capsules containing placebo. Both were submitted to the same anesthetic technique and post-operative analgesic regimen. Pain was evaluated through visual numeric scale (ENV) in 24 hours, 3 and 6 months after the surgery. The morphine consumption was also registered on the first 24 hours after the surgeries and the anxiety levels were measured through the HADS scale on the first 24 hours and after three and six months. The groups were similar regarding demographic data. There was no difference on the incidence of pain on the first 24 hours, after three and six months of the procedures, although there was a significative reduction on the morphine consumption on the first 24 hours on the group Pregabaline. There was no significant difference on the anxiety levels. In this study, the use of pregbaline on the perioperative period did not demonstrate significant reduction on the incidence of chronic post-operative pain, although demonstrated a significant reduction on the consumption of opioids on this period.