Dr. Rosen on the use of preoperative pregabalin for ureteroscopy

In this video, Geoffrey Rosen, MD, discusses the background and findings of the study, “Single Dose Preoperative Pregabalin in Ureteroscopy – Results of a Randomized Controlled Trial,” which was presented at the 2023 American Urological Association Annual Meeting in Chicago, Illinois. Rosen is a chief resident at the University of Missouri.

Video Transcript:

What is the background of this study?

This all started when I was first getting into training, and I was taking care of patients who had kidney stone procedures. Afterwards, a lot of them have trouble with pain. There are all sorts of data out there about different things you can use to try to help with this pain, and we wanted to see if there was anything more that we could do. In our institution, we'd been using enhanced recovery protocols in some of our other surgeries that use pregabalin, so we wanted to see if we could use pregabalin in this setting. So, that's how this trial started. We just looked, and one of our emails to get this trial going was sent July 28, 2018, so it's been a long time in the making.

What were some of the notable findings? Were any of those surprising?

I guess the finding that threw us off at the beginning, was that the people who would receive the medicine, when compared to the people who had received placebo, they actually had more pain. We'd been blinded for the whole time of the study and through the beginning statistics, so this was shocking to us. We even called the pharmacy that did the blinding, and we were like, "are you sure that this is correct?" Because if anything, we would have expected the other. They got back to us, and they were like, "we're very certain that this is the way it was." So that was an initially surprising finding. We dug a little more into the data, and we saw that patients who'd gotten the medicine were younger, and younger patients tend to report higher pain scores. They also had a little bit higher preoperative pain scores. Once we took all that into account, it got rid of the difference, basically.

This transcription has been edited for clarity.