Comparison of pregabalin versus ketamine in postoperative pain management in breast cancer surgery

Abstract

Background:Breast surgery compromises one of the most common cancer surgeries in females and commonly followed by acute postoperative pain. Pregabalin and ketamine have been used in many previous studies and was found to have a good analgesic profile. We assumed that pregabalin and ketamine can be used in control of postoperative pain in female patients undergoing breast cancer surgery.Material and Methods:Ninety female patients scheduled for cancer breast surgery were allocated in three groups (30 patients each), control group (group c) received preoperative placebo, pregabalin group (group p) received oral 150 mg pregabalin 1 h before surgery, ketamine group (group k) received intravenous (IV) 0.5 mg/kg ketamine with induction of anesthesia followed by 0.25 mg/kg/h IV throughout the surgery. All patients received general anesthesia and after recovery, the three groups were assessed in the first postoperative 24 h for postoperative visual analog scale (VAS), total 24 h morphine consumption, incidence of postoperative nausea and vomiting (PONV), sedation score >2 and any complications from the drugs used in the study.Results:The use of pregabalin or ketamine was found to reduce total postoperative morphine consumption with P < 0.001. There was no difference between pregabalin and ketamine groups in opioid requirement. There was no difference between the three groups in postoperative VAS scores or incidence of PONV and sedation score >2.Conclusion:The use of preoperative oral 150 mg pregabalin 1 h before surgery or IV 0.5 mg ketamine with induction of anesthesia can reduce postoperative opioid consumption in breast cancer surgery without change in sedation or PONV and with a good safety profile.

Comparative Study between Oral Pregabalin versus Intravenous Low Dose Ketamine for Post-Operative Pain Management in Laminectomy

“…Our results in the pregabalin group are in agreement with those of Mahran and Hassan [29] and Gupta et al, [33] who found no significant difference in the incidence of dizziness or visual disturbance in their study group compared to the control group.…”

“…Also, our results in the pregabalin group are supported by Jokela et al, [34] , Zhang et al, [27] , Kim et al, [28] , Bornemann-Cimenti et al, [31] , and Mahran and Hassan [29] , all of them reported no significant difference between pregabalin and control groups in their study.…”

“…Also, Mahran and Hassan [29] found that only one patient in the pregabalin group had a sedation score >2 with no significant difference among their three studied groups.…”

“…In addition, Mahran and Hassan [29] found that the use of pregabalin and ketamine reduced the total post-operative morphine consumption. However, there was no significant difference between ketamine and pregabalin groups in opioid requirement.…”

Effect of ketamine combined with butorphanol on emergence agitation of postoperative patients with gastric cancer

“…In the clinic, both ketamine and butorphanol have been proven to be the effective drugs for analgesia. 7 – 9 Mahran and Hassan 21 reported that ketamine is effective in postoperative pain management in breast cancer surgery. Minoshima et al 22 also proved that ketamine could play an important role post-operation following adolescent idiopathic scoliosis surgery.…”