Objective  To explore the effect of pregabalin on sleep of patients after video-assisted thoracic surgery (VATS).

Methods  120 cases of patients undergoing VATS under general anesthesia were randomly divided into 75 mg pregabalin group (group A), 150  mg pregabalin group (group B), and placebo group (group C), with 40 patients in each group. On the night of the operation, the morning and evening of the first day and the second day after the operation, the patients in the three groups were given one tablet of pregabalin (75  mg), one tablet of placebo with the same shape and smell, two tablets of pregabalin (150  mg) and two tablets of placebo with the same shape and smell respectively. Athens insomnia scale (AIS) was used to evaluate the incidence of postoperative sleep disturbance (PSD) on the night of operation, and the patients' sleep quality every night from one night before operation to the 2nd day after operation was assessed using the St. Mary’s Hospital sleep questionaire (SMH). Pittsburgh sleep quality index (PSQI) was used to evaluate the patients' sleep quality one day before the operation, 7 days after operation, and 1 month after the operation. The digital rating scale (NRS) was used to evaluate the patients' pain at the incision and the surgical side. The remedial analgesia, incidence of adverse events in the 72 h postoperative period, and patient satisfaction score were recorded.

Results  The incidence of PSD in group A, group B and group C was 45.0%, 42.5% and 72.5%, respectively, the incidence of group A and group B was significantly lower than in group C (group A, B and C compared in pairs, P<0.016 7). The SMH scores in group A and group B were significantly higher than in group C on the day of operation, the first day and the second day after operation (group A, B and C compared in pairs, P<0.016 7). The incidence of NRS scores in groups A and B at the incision and postoperative remedial analgesia was significantly lower than in group C on postoperative day 1 and postoperative day 2 (group A, B and C compared in pairs, P<0.016 7). There was no statistically significant difference in the pain scores at the incision and shoulder among the three groups at the remaining time points. The postoperative patient satisfaction scores were significantly higher in group A and group B than in group C (P<0.01). The incidence of dizziness in group B was significantly higher than in the other two groups (P<0.016 7).

Conclusion  Oral administration of pregabalin (75 mg/150 mg) for 3 days after VATS can reduce the incidence of PSD and improve the quality of sleep that night, but oral administration of 150 mg pregabalin may increase the incidence of dizziness.

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