Limaprost or Pregabalin: Preoperative and Postoperative Medication for Pain due to Lumbar Spinal Stenosis. Issue 5 (15th December 2017)

• Record Type: Journal Article
• Authors: Kasukawa, Yuji; Miyakoshi, Naohisa; Kobayashi, Takashi; Kikuchi, Kazuma; Ebata, Kunio; Ishikawa, Noriyuki; Suzuki, Tetsuya; Sasaki, Hiroshi; Hatakeyama, Yuji; Hongo, Michio; Ishikawa, Yoshinori; Kudo, Daisuke; Abe, Toshiki; Okuyama, Koichiro; Kido, Tadato; Chiba, Mitsuho; Segawa, Toyohito; Suzuki, Masazumi; Mizutani, Takashi; Kimura, Ryota; Ono, Yuichi; Iida, Jumpei; Abe, Eiji; Shimada, Yoichi
• Is Part Of: Pain practice. Volume 18:Issue 5(2018:Jun.)
• Page Start: 625
• Page End: 630
• Publication Date: 2017-12-15
• Subjects: postoperative pain -- lumbar spinal stenosis -- conservative treatment -- limaprost -- pregabalin; Pain -- Treatment -- Periodicals; 616.0472
• DOI: 10.1111/papr.12653
• Languages: English
• ISSNs: 1530-7085

Abstract

Abstract: Purpose: We aimed to evaluate the incidence of (and risk factors for) postoperative pregabalin and/or limaprost to treat persistent numbness and/or pain of the lower extremities after lumbar spinal stenosis (LSS) surgery. Methods: Medical records of 329 patients (168 men, 161 women; average age 70 years) were retrospectively reviewed for data on the duration of LSS diagnosis; LSS disease; preoperative medication (limaprost, pregabalin, or combined limaprost/pregabalin; duration); symptoms; preoperative/postoperative intermittent claudication (IC); operation type; and postoperative medication and period. Results: Limaprost, pregabalin, and combined limaprost/pregabalin were prescribed preoperatively for 43%, 7%, and 5% of patients, respectively. At an average of 21 months postoperatively, limaprost, pregabalin, and combined therapy were prescribed in 11%, 8%, 4% of patients, respectively. Medication requirement was significantly lower postoperatively than preoperatively ( P < 0.0001). Significant risk factors for required postoperative medication were required preoperative medication (odds ratio [OR] 3.088, 95% confidence interval [CI] 1.679 to 5.681]; postoperative period (OR 1.063, 95% CI 1.031 to 1.096); and postoperative IC (OR 3.868, 95% CI 1.481 to 10.103). A negative impact from postoperative medication was seen in patients who had undergone decompression surgery (OR 0.589, 95% CI 0.377 to 0.918). Conclusions: Overall, 23% of LSS patients required medication for pain and/or numbness at 21 months postoperatively. Significant factors portending required postoperative medication were preoperative medication, longer postoperative period, and postoperative IC. A negative influence from postoperative medication was seen in patients who had undergone decompression surgery without fusion.