A Comparative Evaluation of Pre-Emptive Doses of Gabapentin and Pregabalin for Postoperative Relief of Pain in Patients Scheduled for Surgery Under General Anaesthesia

Abstract

OBJECTIVETo evaluate the comparative pre-emptive effects of gabapentin and pregabalin on postoperative pain in patients scheduled for surgery under general anaesthesia. MATERIAL AND METHODS90 patients of ASA grade I and II posted for elective surgeries under general anaesthesia were randomised into 3 groups (Group G, P and C of 30 patients each). One and a half hour before surgery, the drug selected for the study was given blindly with a sip of water. Group G -Received 600 mg Gabapentin capsule; Group P -Received 300 mg of pregabalin capsule; Group C -Received identical placebo capsule. Pain (Visual analogue score) and side effects assessments were performed immediately and then at 15 mins., 30 mins., 45 mins., 60 mins., 90 mins., 120 mins. and at 180 mins. postoperatively. RESULTSThe mean (±SD) of VAS score was 5.86±0.34 in group C, 5.10±0.84 in group G and 4.96±1.03 in group P. VAS score were significantly lower in both groups G and P as compared to group C. Time for analgesic requirement is more with oral pregabalin than gabapentin and control group. The mean (±SD) TRA-I was 38.40±24.61 in group C, 44.03±8.94 in group G and 58.69±25.21 in group P. Pregabalin causes more sedation than gabapentin. No significant difference was observed among the three groups regarding side effects during the study period. CONCLUSIONOur study demonstrated that pre-emptive oral pregabalin 300 mg and oral gabapentin 600 mg significantly decreases the severity of pain postoperatively in patients posted for surgery under general anaesthesia. Oral pregabalin produces higher degree of sedation as compared to oral gabapentin.

Pre-emptive gabapentin versus pregabalin for acute postoperative pain management in head and neck surgeries under general anaesthesia

“…Mishra R, et al in 2016 did a comparative clinical study on gabapentin (900mg) and pregabalin (150mg) for postoperative pain relief in laparoscopic cholecystectomy under general anaesthesia. They found that sedation score in pregabalin group was significantly higher as compared to gabapentin and placebo group but there was no significant difference between pregabalin and gabapentin group [18] . Even though different dosage of gabapentinoids were used, this finding correlates with our study except no placebo group was included.…”

“…But this was not in concordance with Gautam A, et al who conducted a study in 2016 to evaluate the efficacy of gabapentin (600mg) and pregabalin (300mg) for acute postoperative pain relief in patients scheduled for surgery under general 74 anaesthesia. They concluded that pregabalin causes more sedation than gabapentin [18] that may be due to different dosage of gabapentinoids used. Mishra R, et al in 2016 did a comparative clinical study on gabapentin (900mg) and pregabalin (150mg) for postoperative pain relief in laparoscopic cholecystectomy under general anaesthesia.…”

A comparison of the preemptive effects of oral pregabalin and gabapentin on acute postoperative sedation and complications in patients undergoing lumbar spine surgery

“…Pregabalin was found to cause more sedation than gabapentin without causing any intraoperative hemodynamic changes (Khetarpal et al 2016, Thakur et al 2019, or having any other major side effects besides sedation (Gautam et al 2016). Pregabalin and gabapentin have both been used for their sedative effects, but research is being done to find a medication that is more effective at controlling hemodynamic variables (Maharjan et al 2019).…”

“…Gabapentinoids, as a part of multimodal analgesia, are commonly administered preoperatively, as they have been shown to reduce postoperative opioid consumption and pain scores, mainly for surgical procedures with a high tendency for tenacious postoperative pain (Joshi & Kehlet 2019). Despite the effective preemptive effect of pregabalin and gabapentin in decreasing postoperative pain even when combined with different anaesthesia techniques (Gautam et al 2016, Khetapara et al 2016, 2020, Maharjan et al 2019, Surana et al 2017, Thakur et al 2019, Vasanthy & Sandeep 2019), sedation has always been a concern because of their sedative side effects (Onakpoya et al 2019, Rose & Kam 2002).…”