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Background and Aims Postoperative pain after orthopedic surgery is severe and prolonged. Persistent severe postoperative pain in the first 24 hours is a significant factor in the chronicization of pain. The treatment should be early, multimodal, and aimed at antinociceptive, anti-inflammatory, and antihyperalgesic effects. Several studies have reported that preoperative use of gabapentinoids primarily reduces initial postoperative pain and spares the use of opioids. We conducted a prospective, randomized, single- blind study to evaluate the effect of this molecule in reducing postoperative pain and overall analgesic consumption, particularly morphine.

Methods Sixty patients aged between 20 and 75 years, scheduled for non-urgent orthopedic surgery under spinal anesthesia and classified as ASA I/II, were randomized into two groups: G1 and G2 (receiving 75 mg of pregabalin orally 2 hours before the surgery).We evaluated intraoperative hemodynamic parameters, patient anxiety at arrival and departure from the operating room, postoperative pain using the visual analog scale

Results The demographic characteristics of our population were comparable between the two groups, as was the surgical indication. There was a significant difference in pain evaluation scores at H6 and H24, which were lower in the G2 group, along with a reduction in morphine consumption in the same group, although without significant difference.

Conclusions The administration of 75 mg of pregabalin preoperatively reduces postoperative pain and morphine consumption. All therapeutic strategies should be implemented perioperatively to relieve the patient and prevent the risk of chronic postoperative pain. Controlling postoperative pain allows for early patient mobilization, which is beneficial for better functional outcomes.