Pre-Emptive Analgesia With Pregabalin and Celecoxib Decreases Postsurgical Pain Following Maxillomandibular Advancement Surgery: A Randomized Controlled Clinical Trial

Purpose The purpose of this study was to determine the efficacy of pre-emptive analgesia with pregabalin and celecoxib on narcotic consumption and perceived pain in adult patients undergoing maxillomandibular advancement surgery for obstructive sleep apnea. Patients and Methods This was a prospective, randomized, double-blinded, placebo-controlled study of adult patients undergoing elective maxillomandibular advancement surgery for obstructive sleep apnea. The groups received a masked 1-time preoperative oral dose of pregabalin 150 mg and celecoxib 400 mg (experimental group) or lactose powder 2 g (placebo group). In the postoperative period, pain management consisted of intravenous morphine patient-controlled analgesia and oral oxycodone 5 mg and acetaminophen 325 mg. Patients completed a daily pain and narcotic log. Statistical significance between group means was determined by the 2-tailed independent t test. Results There were statistically significant differences between the pregabalin plus celecoxib and placebo groups in average intravenous morphine consumption per 4-hour interval (6.0 ± 5.9 vs 9.3 ± 7.9 mg; P < .05), mean daily narcotic pill consumption (2.9 ± 2.9 vs 6.8 ± 1.8 pills; P < .05), and mean daily visual analog scale scores (4.3 ± 3.5 vs 5.5 ± 5.0; P < .05). Conclusion Within the limitations of this study, a 1-time preoperative oral dose of pregabalin and celecoxib before adult maxillomandibular advancement surgery for obstructive sleep apnea decreased mean intravenous morphine consumption, mean daily narcotic pill consumption, and mean patient perceived pain.