Pregabalin as an Adjunct Analgesic in Multimodal Pain Management in Patients Presenting with Acute Peri-Anal Fissure

Abstract

Objective: To assess whether Pregabalin has a role as an adjunct analgesic in anal fissures along with standard conservative treatment.

Study Design: Quasi-Experimental Study.

Place and Duration of Study: Sir Ganga Ram Hospital, Lahore Pakistan, from Nov 2021 to Mar 2022.

Methodology: Thirty patients that fulfilled the inclusion criteria presenting to the Outpatient Department of General Surgery were enrolled in the study and assigned to either the standard Treatment-Group or the Pregabalin-Group. Patients were given standard treatment consisting of 0.2% topical GTN cream, stool softeners and analgesics in the form of NSAIDs and Paracetamol for their acute anal fissure, or they were given standard treatment with adjunct Pregabalin 50mg twice a day. The numerical pain score was recorded at enrollment after one week of follow-up.

Results: There was a significant difference between the change in visual analogue scores from baseline between both groups, (p-value of 0.008). There was a significant difference between days till maximum pain relief was achieved between the two groups (p-value of 0.01). 29(96.6%) of fissures were caused due to constipation.
Conclusion: Pregabalin provides modest analgesic effects in anal fissures and may be used as an adjunct analgesic in patients with severe pain.