Sixty patients undergoing lower limb orthopedic surgeries were randomized to receive either 150 mg pregabalin (n=30) or a placebo (n=30) two hours before surgery. The primary outcome was post-operative pain intensity measured by the Visual Analog Scale (VAS) at 6, 12, 24, and 48 hours. Secondary outcomes included total tramadol consumption over 48 hours and incidence of adverse effects. Pain intensity was significantly lower in the pregabalin group at 6, 12, and 24 hours post-surgery, with reduced tramadol requirements. Adverse effects such as nausea and dizziness were minimal and comparable between groups. Overall, the study revealed that pre-operative pregabalin provides better pain relief within the first 24 hours and reduces opioid consumption, suggesting its efficacy as pre-emptive analgesia for orthopedic surgeries.