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Pain Research and Management
Volume 18 (2013), Issue 3, Pages 127-132
http://dx.doi.org/10.1155/2013/258714
Original Article

An Intensive Perioperative Regimen of Pregabalin and Celecoxib Reduces Pain and Improves Physical Function Scores Six Weeks after Total Hip Arthroplasty: A Prospective Randomized Controlled Trial

Nicole ME Carmichael,1 Joel Katz,2 Hance Clarke,2 Deborah Kennedy,1 Hans J Kreder,3 Jeffrey Gollish,1 and Colin JL McCartney1

1Department of Anesthesia, Sunnybrook Holland Orthopedic and Arthritic Centre, Toronto, Ontario, Canada
2University of Toronto, Toronto General Hospital, Toronto, Ontario, Canada
3Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada

Copyright © 2013 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

BACKGROUND: Despite the success of total hip arthroplasty (THA), some patients experience persistent pain and poor function after surgery. Predictors of poor outcomes include the presence of significant pre- and postoperative pain. Patients undergoing THA often experience severe, longstanding pain before surgery that may compromise the outcome of the procedure.

OBJECTIVES: To evaluate the effects of administering pregabalin and celecoxib for two weeks before and three weeks after THA in patients with moderate to severe pain before surgery. The aim was to determine whether patients with well-controlled pain both before surgery and in the acute postoperative period experience less pain and better physical function six weeks after THA.

METHODS: A randomized, double-blinded, placebo-controlled pilot study was conducted. Group 1 received pregabalin (75 mg twice per day) and celecoxib (100 mg twice per day) for 14 days before THA and for three weeks after discharge. Group 2 received a placebo for the same duration. All patients received pregabalin and celecoxib 2 h before surgery and while in the hospital.

RESULTS: On the morning of surgery, patients in group 1 reported less pain at rest (mean [± SD] pain intensity measured on a visual analogue scale [VAS] 2.1±1.4) compared with group 2 (3.3±1.9; P=0.04). Patients in group 1 experienced less pain 3 h to 4 h postoperation (P<0.001). There was no difference in morphine consumption between the two groups. Six weeks after THA, movement-evoked pain was lower in group 1 (VAS 0.8±0.6) compared with group 2 (VAS 2.0±1.3; P=0.01). Group 1 reported better physical function, measured using the Western Ontario and McMaster University Osteoarthritis Index questionnaire score (P=0.04). There was no significant difference in 6 min walk test performance between the two groups.

CONCLUSION: Intensive pain control with pregabalin and celecoxib improves pain and physical function after THA.