Effect of Pregabalin and Dexamethasone on Postoperative Analgesia after Septoplasty

Abstract

Objectives. The aim of this study was to explore effect of a combination of pregabalin and dexamethasone on pain control after septoplasty operations. Methods. In this study, 90 patients who were scheduled for septoplasty under general anesthesia were randomly assigned into groups that received either placebo (Group C), pregabalin (Group P), or pregabalin and dexamethasone (Group PD). Preoperatively, patients received either pregabalin 300 mg one hour before surgery, dexamethasone 8 mg intravenously during induction, or placebo according to their allocation. Postoperative pain treatment included tramadol and diclofenac sodium 30 minutes before the end of the operation. Numeric rating scale (NRS) for pain assessment, side effects, and consumption of tramadol, pethidine, and ondansetron were recorded. Results. The median NRS score at the postoperative 0 and the 2nd h was significantly higher in Group C than in Group P and Group PD (P ≤ 0.004 for both). The 24 h tramadol and pethidine, consumptions were significantly reduced in Groups P and PD compared to Group C (P < 0.001 and P < 0.001). The incidence of blurred vision was significantly higher in Group PD compared to Group C within both 0–2 h and 0–24 h periods (P = 0.002 and P < 0.001, resp.). Conclusions. We conclude that administration of 300 mg pregabalin preoperatively may be an adequate choice for pain control after septoplasty. Addition of dexamethasone does not significantly reduce pain in these patients.

Perioperative Analgesia for Patients Undergoing Septoplasty and Rhinoplasty: An Evidence‐Based Review

“…Seven studies investigated the efficacy of gabapentinoid use as an analgesic . All of the included studies were prospective, double‐blinded RCTs.…”

“…Gabapentinoids were compared to placebo in all seven articles. Kim et al dosed pregabalin at 150 mg, whereas Demirhan used doses of 300 mg . Gabapentinoid doses varied and were 300 mg in the study by Farzi et al, 600 mg in Kazak et al’s study, compared to 1,200 mg for Turan et al and Salama and Amer .…”

“…Four studies examined the use of steroids, specifically dexamethasone, in conjunction with local anesthetics and gabapentinoid medications . In the two local anesthetic studies, the addition of dexamethasone resulted in significantly decreased perioperative VAS scores as well as rescue analgesic consumption.…”

Does preoperative administration of gabapentin/pregabalin improve postoperative nasal surgery pain?

“…Data from eligible studies were extracted using standardized forms and were checked by the two reviewers individually. Analyzed outcomes were postoperative pain (pain scores after leaving the operating room), postoperative (24 hours) analgesic intakes (either quantity or incidences of patients taking postoperative opioids or nonopioid analgesics), time to first‐administered analgesic (opioid or nonopioid analgesic administered with a defined pain intensity target), the events of postoperative nausea and vomiting (PONV) (incidence of patients), dizziness, headache, blurred vision, or operative blood loss and operative field visibility . These outcomes were compared in the preoperative gabapentinoids group (including oral administration) versus the control group (patients who used no treatment or analgesics) in the postoperative period (0 to 24 hours after leaving the operating room).…”

“…Nasal surgeries, such as septoplasty, rhinoplasty, and endoscopic sinus surgery, have drastically improved over time, although these procedures were commonly performed by the mid‐19th century . However, postoperative pain is a common problem after nasal surgery operations despite improvements in surgical techniques, and the clinical reality is, unfortunately, still far from satisfactory despite increasing pursuit of effective postoperative pain control . Opioid and nonopioid analgesics are widely used to treat postoperative pain.…”