As with many anticonvulsants, pregabalin is enjoying an ever increasing spectrum of use. Originally licensed for the treatment of epilepsy, diabetic neuropathic pain and post-herpetic neuralgia; pregabalin has become a staple of the chronic pain armamentarium. To date, well over 100 studies have explored pregabalin's use in the perioperative period on a diverse range of symptoms including acute pain and preoperative anxiety. This issue of the BJA carries a meta-analysis looking at the utility and prescribing rationale for pregabalin in the peri-operative period. In this podcast Dr Ashraf Habib from Duke University Medical Centre takes us through the potentially practice changing evidence for pregabalin use in the perioperative period.