Gabapentin versus Pregabalin for Postoperative Pain: A Randomized Placebo-Controlled Trial

To evaluate the efficacy of pregabalin and gabapentin for post-photorefractive keratectomy (PRK) pain relief. 150 patients were divided into 3 groups. After undergoing PRK; groups 1, 2, 3 received pregabalin 75 mg, gabapentin 300 mg, and placebo 3 times daily for 3 days, respectively. Patients could take acetaminophen-codeine 300/10 mg tablets every 4 hours as needed. Patients completed a pain assessment survey (visual analogue scale ranging from 0 = no pain to 10 = most severe pain) 7 times in the first 3 days following PRK and also recorded the number of consumed acetaminophen-codeine tablets. The three groups were similar in terms of age, sex, refractive error, ablation depth, and mitomycin-C (MMC) application (all p values>0.05). Overall, pain score in the placebo group was higher than the pregabalin (P=0.029) and gabapentin (P=0.023) groups, respectively. Severe pain (score >7) was more frequent in the placebo group on the morning of the first postoperative day (P=0.043). The number of consumed acetaminophen-codeine tablets was lower in the pregabalin and gabapentin groups than the placebo group,but this difference didnt reach statistical significance (P=0.061). Pregabalin and gabapentin are helpful in alleviating post-PRK pain when combined with other medications. Depending on availability, either compound can be used as an adjuvant for pain control in this setting.