The effect of pregabalin for pain after third molar surgery: a systematic review and meta-analysis
Abstract
Background: Pregabalin has been proposed as an adjunct for postoperative pain management following third molar surgery, but its analgesic efficacy, safety, and clinical applicability remain uncertain. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) ascertaining pregabalin for pain after third molar extraction.
Methods: A systematic search was conducted across PubMed, Scopus, Web of Science, and Google Scholar up to January 2025. RCTs appraising pregabalin for postoperative pain following third molar surgery were included. The primary outcome was pain intensity (VAS) and the secondary outcome was adverse events (AEs). Data were pooled using a random-effects meta-analysis, with mean difference (MD) for pain scores and odds ratio (OR) for AEs, each with 95% confidence intervals (CIs). Risk of bias was assessed using the Cochrane RoB 2 tool.
Results: Six RCTs involving 545 patients undergoing third molar surgery were included. Of these, 170 patients (4 RCTs) contributed data to the quantitative synthesis. Pregabalin significantly mitigated postoperative pain compared with control (MD - 0.99, 95% CI - 1.46 to - 0.52, p < 0.00001), though substantial heterogeneity was observed (I²=91%). Subgroup analysis by timepoint revealed consistent but individually nonsignificant reductions in pain at 2-24 h postoperatively. Pregabalin use was linked to a higher risk of adverse events (OR 4.36, 95% CI 2.52-7.55, p < 0.00001, I²=77%), with a…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 545 participants or records.
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