TITLE:
Preoperative Sedation, Hemodynamic Stability during General Anesthesia and Improving Postoperative Pain: Pregabalin Is the Answer
AUTHORS:
Heba El-Hussiny, Huda Fahmy, Ayman Mohammad Eldemrdash
KEYWORDS:
Pregabalin, Premedication, Sedation, Postoperative Pain
JOURNAL NAME:
Open Journal of Anesthesiology,
Vol.8 No.1,
January
29,
2018
ABSTRACT:
Background: Tracheal intubation is a noxious stimulus that tends to provoke
a marked sympathetic response which is potentially deleterious in some patients.
Various methods have been used to minimize and attenuate these potentially
harmful responses. Aim of the study: The present study compared
the efficacy and safety of two different doses (150 mg and 300 mg) of oral
pregabalin premedication on attenuation of the hemodynamic pressor response
to airway instrumentation, perioperative hemodynamic stability,
preoperative sedation, and postoperative pain reduction. Patients and methods: This prospective, observational study consisted of 60 adult patients
scheduled for laparoscopic cholecystectomy. The patients were randomized
into three groups of 20 patients each. Group I (P0) received an oral placebo,
group II (P150) received 150 mg of oral pregabalin and group III (P300) received
300 mg of oral pregabalin 1 h prior to induction. All patients were assessed
for pre-operative sedation, perioperative hemodynamic changes,
Post-operative pain and analgesic consumption. Results: Regarding the efficacy
of the preoperative administration of oral pregabalin, a dose dependent
attenuation in the increased in heart rate, systolic, and diastolic blood pressure,
and mean arterial blood pressure resulting from laryngoscopy and intubation
was observed (300 mg > 150 mg), along with a subsequent decrease in
intraoperative fentanyl supplementation. On anxiolysis, patients were more
comfortable and asleep in the pregabalin groups as compared with the control
group, in which more patients were awake and agitated. Post-operative pain
and analgesic consumption were effectively reduced by (150 mg and 300 mg)
pregabalin in a dose-dependent manner. Postoperative nausea and vomiting
were significantly lower with the administration of pregabalin compared with
the placebo group (P Conclusion: Oral pregabalin premedication adequately sedated patients and attenuated
the hemodynamic pressor response to airway instrumentation in a
dose-dependent manner. Premedicated patients were haemodynamically stable
perioperatively without recovery time prolongation or side effects, except
dizziness with 300 mg of oral pregabalin. Additionally, oral pregabalin reduced
postoperative pain and analgesic consumption in a dose-dependent
manner.