Efficacy of Pre Gabalin in Immediate Post - Operative Pain Control

Abstract

BACKGROUND: Ant nociceptive treatment started before surgery is more effective in reducing postoperative pain than if started in early postoperative period. Pregabalin has demonstrated efficacy in clinical trials as pre-emptive analgesic in postoperative pain management. OBJECTIVE: This was a prospective, double blind, controlled, randomized, comparative study between pre-emptive oral pregabalin and placebo. Randomization was done by computer generated random table method; random sequence was generated by random allocation software. It was conducted in order to evaluate postoperative analgesic benefit in patients administered pregabalin for below umbilical surgeries to be performed under subarachnoid block (SAB) using 3ml 0.5%bupivacaine & to compare their postoperative efficacy with respect to duration of analgesia,24hrs postoperative requirements of total analgesics and study side effects. MATERIAL & METHODS: sixty patients of either sex (30 per group,20-65yrs, ASA gr I-II) received either oral placebo (group PC) or pregabalin 300mg (group PG) one hr preoperatively. The postoperative Visual Analogue Scale (VAS) score was assessed for 24hrs every 2hrly. The patients were given iv Diclofenac75mg as rescue analgesic at VAS ≥4.The time at which patient demanded rescue analgesic for first time & total requirement of 24 hrs postoperative analgesics was noted. STATISTICAL ANALYSIS: Software used in the analysis was EPI info software (3.4.3). Data was reported as mean value ± SD, P-value of < 0.05 was considered statistically significant. Unpaired T-test was used to find out significance between two samples. The comparison of normally distributed continuous variables between the groups was performed by means of one-way analysis of variance (ANOVA) and, if appropriate, followed by Dunnett multiple comparison tests. Nominal categorical data among study groups were compared using the chi-square test. RESULTS: Total duration of analgesia in Group-PG was significantly more than Group-PC. (632.83±103.95, Group-PG and 264.83±13.67 min. Group-PC, p=0.000), lower rescue analgesic requirement in Group-PG than in Group-PC (1.73±0.44 Group-PG, 4.03±0.66 Group-PC, p=0.000). CONCLUSION: Pregabalin proved to have a better analgesic effect, reducing the total consumption of postoperative analgesic and prolonging first rescue analgesic dose with haemodynamic stability. The main side effects were somnolence & dizziness.

Addition of Dexamethasone Injection to Preemptive Oral Pregabalin Does Not Improve Postoperative Analgesia Over Pregabalin Alone for Abdominal Hysterectomy Under General Anaesthesia

“…Also, it plays an important role as preventive or protective analgesia by minimizing the incidences of chronic postsurgical pain syndrome when administered as oral pre-emptive analgesic for postoperative pain relief. 10 Pregabalin is better than its congener gabapentin in terms of increased potency, better oral bioavailability (90%), quicker onset of action (1 hour), and less side effects. 3 It has also got anxiolytic property.…”