Does pregabalin help with post-tonsillectomy pain?
Reviewed by Vik Veer

This is a small double-blind randomised controlled trial conducted on tonsillectomy and lateral pharyngoplasty operations. Both of these operations are terrifically painful, and I am sure most of us are looking for a way of reducing the suffering for our patients. Although there have been some papers indicating that gabapentinoids are useful for modifying pain levels after operations, it seems that this was not obvious in this study of 34 patients. It seems that pregabalin did not reduce postoperative pain intensity, nor did it reduce the amount of opiates required. The only significant finding was that it reduced dizziness postoperatively. My further reading of the subject suggests that these drugs are better for neuropathic pain rather than this mucosal and muscular cramping pain. In my own practice for lateral pharyngoplasties I use 0.3mcg – 0.5mcg/kg ketamine after induction as an opiate sparing medication in the first 48 hours after surgery. It is a shame that these medications seem to be of no (or very little) benefit to patients after these types of operations.

Does pregabalin act in pain control after lateral pharyngoplasties and tonsillectomies? A pilot study.
Rocha L, Mello L, Silva D, et al.
SLEEP BREATH
2023;27:1107–10.