Addition of Celebrex and Pregabalin to Ropivacaine for Posterior Spinal Surgery: A Randomized, Double-Blinded, Placebo-Controlled Trial

Abstract

Background

Serious pain commonly occurs after posterior spinal surgery. This study aims to evaluate the effect of preemptive and multimodal analgesia using celebrex, pregabalin and ropivacaine on pain control after this surgery.

Methods

Ninety-three patients undergoing posterior spinal surgery were enrolled in this prospective, randomized, double-blind, placebo-controlled clinical trial. All patients were treated with patient- controlled analgesia (PCA, intravenous tramadol hydrochloride and flurbiprofen) as required. They were randomized to combination analgesia intervention (oral celebrex, pregabalin and subcutaneous infiltration of ropivacaine), ropivacaine intervention (only subcutaneous infiltration of ropivacaine), and control intervention (placebo). We compared postoperative visual analog scale (VAS) scores and PCA dose among the three groups.

Results

The VAS scores were significantly lower in the combination analgesia group than in the control group at 0 h, 2 h, 12 h, 24 h, 3 d, 5 d, 7 d and 14 d after posterior spinal surgery, while combination analgesia was also superior to ropivacaine in terms of VAS scores at 24 h and 14 d postoperatively. The combination analgesia group was also associated with significantly reduced PCA consumption compared with the control group, but there was no statistical difference in PCA consumption between the ropivacaine group and control group.

Conclusion

Combination analgesia using celebrex, pregabalin and ropivacaine is effective and safe to alleviate pain after posterior spinal surgery.

Clinical Trial Registration

Chinese Clinical Trial Registry No. ChiCTR2000031236.

Keywords:

• preemptive analgesia
• multimodal analgesia
• pain control
• posterior spinal surgery
• randomized trial

Acknowledgments

This study was funded by Foundation of The First Affiliated Hospital of Chongqing Medical University (PYJJ2018-13) and Natural Science Foundation of Chongqing (cstc2019jcyj-msxmX0836).

Data Sharing Statement

The datasets generated during and/or analyzed during the current study are available in the ResMan Research Manager repository (http://www.medresman.org.cn/uc/sindex.aspx).

Ethics Statement

The study protocol was approved by the Ethics Committee of The First Affiliated Hospital of Chongqing Medical University. The study has been registered in the Chinese Clinical Trial Registry (ChiCTR2000031236). Written informed consent was obtained from all patients.

Disclosure

The authors declare no conflicts of interest in this work.