Friedlander EB, et al. - Researchers assessed if prophylactic pregabalin reduces pain experienced with medication abortion. Findings did not suggest a significant reduction in pain 300 mg pregabalin coadministered with misoprostol during medication abortion vs placebo. They noted a less likeliness of the women who received pregabalin to require any ibuprofen or narcotic and despite an increase in dizziness, sleepiness, and blurred vision, these demonstrated a greater likeliness to report higher satisfaction with analgesia.

Methods

• Authors conducted a randomized, double-blind, placebo-controlled trial of women initiating medication abortion with mifepristone and buccal misoprostol up to 70 days of gestation.
• They randomized the participants to 300 mg oral pregabalin or a placebo immediately before misoprostol.
• Maximum pain on an 11-point numerical rating scale, reported using real-time electronic surveys over 72 hours was included in the primary outcome.
• Pain at each time point, ibuprofen and narcotic use, side effects, and satisfaction were included in the secondary outcomes.
• It was estimated that in order to have 80% power to detect a difference in pain of 1.3 points, 110 women would be required.

Results

• As per data, between June 2015 and October 2016, 241 women were screened and 110 were randomized (56 pregabalin, 54 placebo); three were lost to follow-up.
• In the pregabalin group, the primary outcome of mean maximum pain was 5.0±2.6 vs 5.5±2.2 in the placebo group (P=.32).
• Findings suggested that excluding medication taken before the study capsule, 64% (35/55) of the pregabalin group used ibuprofen vs 87% (45/52) placebo (P < .01).
• A total of 29% (16/55) of the pregabalin group took narcotics vs 50% (26/52) placebo (P < .03).
• In the pregabalin group, more dizziness (P < .001), sleepiness (P < .04), and blurred vision (P < .05) occurred.
• For the analgesic regimen, satisfaction scores were higher in the pregabalin group (very satisfied: 47% vs 22%;P=.006).