1. Targeting pro-nociceptive mechanisms to prevent chronic pain after whiplash injury - a randomised controlled trial
Investigators:
Prof Michele Sterling, Griffith Uni – physio, expert on whiplash injury
Prof Stephan Schug, UWA – anaesthetist & pain specialist
Prof Geoff Mitchell, UQ – GP & primary care
Prof Sam McLean, Uni North Carolina, USA – ED Doctor
Prof Luke Connelly, UQ – health economist
Prof Steve Gibson, Uni Melb – psychologist
Prof Rob Ware, GU - biostatistician
Dr Jane Nikles, MHIQ
Dr Gerben Keijzers, GCUH
Dr John Leou, GCUH
Dr Scott Farrell, MHIQ
Supported by funding from:
- NHMRC
- Motor Accident Insurance Commission
- MHIQ
- Emergency Medicine Foundation

2. Whiplash Associated Disorders
Back and neck pain are the most common cause of disability worldwide (Global Burden of Disease Study, Lancet, 2015)
Whiplash is costly – greater costs than SCI and TBI (MAIC, 2012)
50% of people don’t recover – have chronic pain & disability (Sterling et al 2005, 2010, 2011)
Current treatments aren’t very effective – advice/exercise/activity
The early presence of pro-nociception is predictive of poor recovery – moderate evidence (Goldsmith et al 2012; Sterling et al 2012)

3. Question Why Pregabalin?
Can pregabalin prevent the development of chronic pain after whiplash injury?
Why Pregabalin?
Pregabalin acts to block the development of central sensitisation
Shows promise to prevent chronic post-surgical pain (Clarke et al, 2012; Mishriky et al, 2015; Eipe et al, 2015)
Has effects on anxiety

4. Methodology
Double blind, randomised, placebo-controlled trial comparing
pregabalin and evidence-based advice (intervention) to
placebo and evidence-based advice (control)
Intervention will commence within 48 hours of injury and continue for 5 weeks – monitored by trial GP
75 mg initially, titrated up to 300 mg if tolerated

5. Inclusion Criteria
Individuals with neck complaints and decreased range of motion and tenderness
VAS ≥ 5/10 on arrival without fractures or neurological compromise
Age 18-65
No history of depression or psychiatric dx

6. How can you help?
Identify patients and call Research Team (numbers on posters around ED)
Research staff will do bulk of paperwork, from doctors we need:
Countersign informed consent
Write trial script for Pregabalin

7. How can you help?
If after hours 8.30 am to 8 pm (or research team not available)
 complete Permission to Contact form (name, contact details, signatures from patient and MO/nurse)
Put form back in folder
~30 seconds to 1 minute…

8. Located in folders at Minor Injuries, Resus and Triage

9. Contact Subaat Khan: P: 5552 9772 M: 0414 683 424E:
Dr. Scott Farrell: P: E:
Dr. Jane Nikles:
P: M: E:
Dr. Gerben Keijzers:
P: ‘Speed dial 27734’ E:
Prof. Michele Sterling:
P:   M: E: