Does pregabalin reduce opioid use after surgery for cholelithiasis?
Pregabalin is a medicine that calms overactive nerves and is often used for nerve pain. Some surgeons give it before surgery to lower pain and the need for opioid painkillers afterward. For people having gallbladder removal (laparoscopic cholecystectomy) because of gallstones (cholelithiasis), the evidence suggests pregabalin does reduce opioid use, but the studies are small and their results vary a lot 39.
What the research says
A 2025 systematic review and meta-analysis pooled seven randomized controlled trials of a single 150 mg pregabalin dose given before laparoscopic cholecystectomy 3. It found pregabalin lowered opioid consumption, including fentanyl (SMD 1.24 lower) and tramadol (SMD 4.21 lower), and reduced pain scores at 24 hours 3. Side effects were similar to placebo, with a small, non-significant increase in sedation and no clear differences in nausea, vomiting, or headache 3. The authors noted high variability between studies (I-squared of 81% for pain), so the size of the benefit is uncertain 3.
What to ask your doctor
- Would a preoperative dose of pregabalin fit my surgery and health history?
- What are the trade-offs, such as sedation or dizziness, with pregabalin around surgery?
- How does pregabalin compare with other opioid-sparing pain options for gallbladder surgery, like nerve blocks or local anesthetic infiltration 2?
- What is the plan for managing my pain and opioid use after I go home?
This question is drawn from common patient questions about Anesthesiology & Pain Medicine and answered using cited medical research. We do not provide individualized advice.