G. Dewasi, P. Nagda, S. Jain
Effective postoperative pain control is essential following laparoscopic cholecystectomy, yet the analgesic value of a standardised 150 mg preoperative dose of pregabalin has not been clearly established. This systematic review and meta-analysis synthesised evidence from seven randomised controlled trials published between 2008 and 2025 to evaluate the efficacy and safety of pregabalin when administered before surgery. Four trials reported 24-hour postoperative pain scores, and pooled analysis demonstrated that pregabalin significantly reduced pain compared with control (SMD = -0.80; 95% CI: -1.42 to -0.18; p = .01), although heterogeneity was high (I2 = 81%). Pregabalin also produced notable reductions in opioid consumption, including fentanyl (SMD = -1.24; p = .002) and tramadol (SMD = -4.21; p = .002), again with considerable variability across studies. Sedation was slightly increased but did not reach statistical significance, and there were no significant differences in postoperative nausea, vomiting, or headache. Sensitivity analyses supported the stability of these findings. Overall, the results indicate that a single 150 mg preoperative dose of pregabalin meaningfully reduces postoperative pain and opioid requirements following laparoscopic cholecystectomy while maintaining an acceptable safety profile, supporting its use as part of a multimodal analgesic strategy.