Research Article

Efficacy of Oral Pregabalin Premedication as an Adjuvant to Fentanyl in Patients Undergoing Major Surgeries under General Anesthesia: An Observational Study

Abstract

Background: Intubation and laryngoscopy may raise blood pressure and heart rate unnecessarily. To investigate the effect of Pregabalin premedication on hemodynamic responses to laryngoscopy and intubation.
Methods: A Prospective Observational study was carried out in academic year December 2013 to July 2015 on 60 ASA physical status I or II patients undergoing elective surgery under general anesthesia at tertiary care hospital. 60 patients were divided into two equal groups of 30 each who received either fentanyl (Group A) or oral Pregabalin 150 mg (Group B) 1 hour prior to surgery. Pulse rate, Systoli and diastolic blood pressure were recorded preoperative, and 0,1,3,5 and 10 minutes after induction. Confidentiality of the subject was maintained. Descriptive and inferential statistics for quantitative and categorical variables were analysed using IBM SPSS version 22.
Results: SBP, DBP, and MAP rise during laryngoscopy and during intubation in a similar way in both groups at laryngoscopy (BL) and at 1 and 3 minutes following laryngoscopy before levelling off after 10 minutes in both groups. At baseline and one minute after laryngoscopy, HR increased in both groups. At 3 min, 5 min, and 10 min following laryngoscopy, the rise was reduced in the FL group, however the differences were statistically significant, p 0.005.
Conclusion: Oral Pregabalin premedication at a dose of 150 mg one hour prior to surgery attenuates pressor response associated with laryngoscopy and endotracheal intubation.

[1]Chen W, Huang H, Yang C, Hu X, Bao F, Jiang H. Preoperative Low-dose and High-dose Pregabalin and Cardiovascular Response to Endotracheal Intubation: A Prospective, Randomized, Single-blind, Controlled Study in China. Clin Ther. 2019; 41(1):68-77.
[2]Rastogi B, Gupta K, Gupta PK, Agarwal S, Jain M, Chauhan H. Oral pregabalin premedication for attenuation of haemodynamic pressor response of airway instrumentation during general anaesthesia: A dose response study. Indian J Anaesth. 2012;56(1):49-54.
[3]White PF, Tufanogullari B, Taylor J, Klein K. The effect of Pregabalin on preoperative anxiety and sedation levels: a dose-ranging study. Anesth Analg. 2009;108(4):1140-1145.
[4]Tiippana EM, Hamunen K, Kontinen VK, Kalso E. Do surgical patients benefit from perioperative gabapentin/pregabalin? A systematic review of efficacy and safety. Anesth Analg. 2007;104(6):1545-1556.
[5]Sundar AS, Kodali R, Sulaiman S, Ravullapalli H, Karthekeyan R, Vakamudi M. The effects of preemptive Pregabalin on attenuation of stress response to endotracheal intubation and opioid-sparing effect in patients undergoing off-pump coronary artery bypass grafting. Ann Card Anaesth. 2012;15(1):18–25.
[6]Boerner TF, Ramanathan S. Functional anatomy of the airway. Airway management–Principles and practice, Benumof JL, ed. New York: Mosby Inc. 1996.
[7]Deem SA,Michael B, Robert FB.Physiologic and Pathophysiological Responses to Intubation. In: Carin A Hagberg,Editor.Benumof‘s Airway Management, 2nd Ed.USA: MosbyElsevier; 2007.
[8]Stein PD, Beemath A, Matta F, Weg JG, Yusen RD, Hales CA, et al. Clinical Characteristics of Patients with Acute Pulmonary Embolism: Data from PIOPED II. Am J Med. 2007;120(10):871-879.
[9]Morin AM, Geldner G, Schwarz U, Kahl M, Adams HA, Wulf H, et al. Factors influencing preoperative stress response in coronary artery bypass graft patients. BMC Anesthesiol. 2004;4(1):7.
[10]ovac AL. Controlling the hemodynamic response to laryngoscopy and endotracheal intubation. J Clin Anesth. 1996; 8(1):63-79.
[11]Prys-Roberts C, Greene LT, Meloche R, Foëx P. Studies of anaesthesia in relation to hypertension. II. Haemodynamic consequences of induction and endotracheal intubation. Br J Anaesth. 1971;43(6):531-547.
[12]Parveen S, Negi DS, Kumar R, Bagwan MC. Oral Clonidine vs Oral Pregabalin Premedication to Attenuate Pressor Response to Direct Laryngoscopy in Patients Undergoing Laparoscopic Cholecystectomy: A Randomized Double-Blind Study. J Clin Diagn Res. 2016;10(9): UC21-UC25.
[13]IBM Corp. Released 2013. IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY: IBM Corp.
[14]Gupta K, Sharma D, Gupta PK. Oral premedication with Pregabalin or clonidine for hemodynamic stability during laryngoscopy and laparoscopic cholecystectomy: A comparative evaluation. Saudi J Anaesth. 2011;5(2):179-184.
[15]Ghai A, Gupta M, Hooda S, Singla D, Wadhera R. A randomized controlled trial to compare Pregabalin with gabapentin for postoperative pain in abdominal hysterectomy. Saudi J Anaesth. 2011;5(3):252-257.
[16]Guttuso TJ, Roscoe J, Griggs J. Effect of gabapentin on nausea induced by chemotherapy in patients with breast cancer. Lancet (London, England). 2003;361(9370):1703-1705.
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IssueVol 8 No Supp. 1 (2022): Supplement 1 QRcode
SectionResearch Article(s)
Keywords
Hemodynamic response Intubation Laryngoscopy Pregabalin Sedation

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1.
Shettigar A, Udupi S, Tekchandani D. Efficacy of Oral Pregabalin Premedication as an Adjuvant to Fentanyl in Patients Undergoing Major Surgeries under General Anesthesia: An Observational Study. Arch Anesth & Crit Care. 2022;8(Supp. 1):393-398.