Research Article

Comparative Evaluation of Two Different Doses of Pre-Emptive Oral Pregabalin on Duration of Spinal Anesthesia and Postoperative Pain

Abstract

Background: Pregabalin provides good postoperative analgesia in nociceptive stimuli. Various studies show that preemptive oral pregabalin reduces acute postoperative pain. We conducted a study to evaluate the efficacy of two different doses of pregabalin and its effect on onset and duration of spinal anesthesia and postoperative pain.
Methods: In prospective, double-blind and randomized study, 60 patients posted for vaginal hysterectomy under spinal anesthesia were randomly allocated to two groups recieving cap. Pregabalin 75 mg (group 1) and cap pregabalin 150 mg (group 2) orally, 90 min prior to surgery. Onset and duration of motor and sensory blockade were observed. Postoperative pain was assessed by VAS for 24 hrs. Injection paracetamol 1 gm. was given intravenously as rescue analgesic. Time of first rescue analgesic and total dose of rescue analgesics was noted.
Results: Group 2 patients had better postoperative analgesia in terms of prolonged sensory and motor blockade which correlated well with the time of first request for rescue analgesia (504±123.2 min) as compared to group 1 patients (304.9±37.6 min). Also the total dose of rescue analgesic (paracetamol) was significantly less with 150mg pregabalin (p = 0.0001).
Conclusion: Pregabalin 150 mg prolongs the duration of spinal anesthesia and has better analgesic profile without significant side effects. Thus we conclude that 150 mg pregabalin given preemptively optimizes spinal anesthesia well in patients for vaginal hysterectomy.

[1] Kaya FN, Yavascaoglu B, Turker G, Yildirim A, Gurbet A, Mogol EB, Ozcan B. Intravenous dexmedetomidine, but not midazolam, prolongs bupivacaine spinal anesthesia. Can J Anaesth. 2010; 57(1):39-45.
[2] Kissin I. Preemptive analgesia. Anesthesiology.2000; 93(4):1138-43
[3] Katz J, Clarke H, Seltzer ZE. Preventive analgesia: quo vadimus? Anesth Analg. 2011; 113(5):1242-53.
[4] Rajendran I, Basavareddy A, Meher BR, Srinivasan S. Prospective, randomized, double blinded controlled trial of gabapentin and pregabalin as pre emptive analgesia in patients undergoing lower abdominal and limb surgery under spinal anaesthesia. Indian J Pain. 2014; 28:155-9
[5] Ben-Menachem E. Pregabalin pharmacology and its relevance to clinical practice. Epilepsia 2004; 45 (suppl 6):13–8.
[6] Lam DM, Choi SW, Wong SS, Irwin MG, Cheung CW. Efficacy of Pregabalin in Acute Postoperative Pain Under Different Surgical Categories: A Meta-Analysis. Medicine (Baltimore). 2015; 94(46):e1944.
[7] Mishriky BM, Waldron NH, Habib AS. Impact of pregabalin on acute and persistent postoperative pain: a systematic review and meta-analysis. Br J Anaesth. 2015; 114:10–31.
[8] Cegin MB, Soyoral L, Yuzkat N, Baydi V, Goktas U. Pregabalin administered as an anxiolytic agent in ultrasound-guided infraclavicular block: a controlled, double-blind, dose-ranging trial. Eur Rev Med Pharmacol Sci. 2016; 20(3):568-74.
[9] Park M, Jeon Y. Preoperative pregabalin prolongs duration of spinal anesthesia and reduces early postoperative pain: A double-blind, randomized clinical CONSORT study. Medicine (Baltimore). 2016; 95(36):e4828.
[10] Bafna U, Rajarajeshwaran K, Khandelwal M, Verma AP. A comparison of effect of preemptive use of oral gabapentin and pregabalin for acute postoperative pain after surgery under spinal anesthesia. J Anaesthesiol Clin Pharmacol. 2014; 30(3):373–7.
[11] Rajjappa GC,Vig S,Bevanaguddaiah Y,Anadswamy TC. Efficacy of pregabalin as premedication for post operative analgesia in vaginal hysterectomy. Anesth Pain Med. 2016; 6(3):e34591.
[12] Kohli M, Murali T, Gupta R, Khan P, Bogra J. Optimization of subaracanoid block by oral pregabalin for hysterectomy. J Anesthesiol Clin Pharmacol 2011; 27(1):101-5
[13] Hill CM, Balkenohl M, Thomas DW, Walker R, Mathé H, Murray G. Pregabalin in patients with postoperative dental pain. Eur J Pain. 2001; 5(2):119-24.
[14] Ahiskalioglu A, İnce İ, Aksoy M, Yalcin E, Ahiskalioglu EO, Kilinc A. Effects of a Single-Dose of Pre-Emptive Pregabalin on Postoperative Pain and Opioid Consumption After Double-Jaw Surgery: A Randomized Controlled Trial. J Oral Maxillofac Surg. 2016; 74(1):53.e1-7.
[15] Wang YM, Xia M, Shan N, Yuan P, Wang DL, Shao JH, et al. Pregabalin can decrease acute pain and postoperative nausea and vomiting in hysterectomy: A meta-analysis. Medicine (Baltimore). 2017; 96(31):e7714.
[16] Paech MJ, Gay R, Chua S, Scott K, Christmas T, Doherty DA. A randomized, placebo-controlled trial of preoperative pregabalin for postoperative pain relief after minor gynaecological surgery. Anesth Analg. 2007; 105:1449-53.
[17] Jokela R, Ahonen J, Taligren M, Haanpaa M, Kortilla K. Pretreatment with pregabalin 75 or 150 mg with ibuprofen to control pain after day care gynaecological laproscopic surgery. Br J Anaesth 2008; 100(6):834-40.
[18] Jokela R, Ahonen J, Taligren M, Haanpaa M, Kortilla K. A randomized controlled trial of perioperative administration of pregabalin for pain after laproscopic hysterectomy. Pain. 2008; 134(1-2):106-12
[19] Buvanendran A, Kroin JS, Kari M, Tuman KJ. Can a single dose of 300 mg of pregabalin reach acute antihyperalgesic levels in the central nervous system? Reg Anesth Pain Med. 2010; 35(6):535-8.
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IssueVol 7 No 2 (2021): Spring QRcode
SectionResearch Article(s)
Published2021-05-31
DOI https://doi.org/10.18502/aacc.v7i2.6300
Keywords
Preemptive Pregabalin Post-operative analgesia Spinal anesthesia Vaginal hysterectomy

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How to Cite
1.
Panse N, Adate K, Panchal S. Comparative Evaluation of Two Different Doses of Pre-Emptive Oral Pregabalin on Duration of Spinal Anesthesia and Postoperative Pain. Arch Anesth & Crit Care. 7(2):75-1.