In patients undergoing rotator cuff repair, does the administration of temazapam, amitryptyline or pregabalin improve pain and sleep function compared to placebo.

This study is a prospective, randomized, blinded and placebo controlled trial. We aim to determine if there is a significant difference and improvement when using pregabalin, amitryptyline or temazepam as an adjunct to pain management following rotator cuff repair (RCR). Patients requiring RCR will be randomized to one of four arms of the trial: Group one receives temazepam 10mg/20mg oral tablet, once daily in the evening (NOCTE) from day of surgery to day 14. Group two will receive pregabalin 150mg/300mg oral tablet, once daily (NOCTE) from day of surgery to six weeks post operatively. Group three will receive amityptyline 10mg/20mg oral tablet, once daily (NOCTE) from day of surgery to six weeks post operatively. Group four will receive placebo, oral tablet once daily (NOCTE) from day of surgery to six weeks post operatively. All treatment arms will follow a rule; patients under 70 years of age and over 70kg in weight will receive the larger dose . E.g. Patient #01 is 61 years old and weighs 86kg, therefore they will receive the larger dose provided for their specific treatment arm. Upon discharge, patients will be provided with a 2 week supply of medication. The patient will be asked to bring all of their medication with them to their 2 week post-operative review appointment with the surgeon, so as to monitor adherence to the intervention. All patients in the trial will receive the same standardized multi-modal analgesia, i.e. intra operative scalene nerve block, parental anti-inflammatory and local anesthetic medication, plus oral analgesia as required. Patients who are identified as sleeping and coping poorly (PSQI > 5) will be considered for change of management. Placebo patients will be randomised to a treatment arm, patients in a treatment arm already will have the dosage increased if suitable or will be changed to another treatment arm.