Evaluation of efficacy of pregabalin as premedication for post-operative analgesia in open appendicectomy

Authors

DOI:

https://doi.org/10.18203/2320-6012.ijrms20230174

Keywords:

Open appendicectomy, Post-operative analgesia, Pregabalin

Abstract

Background: Pregabalin is gamma amino butyric acid (GABA) structural analogue, effectively used in management of different neuropathic pain, incisional and inflammatory injuries. Current study aimed to evaluate the efficacy of pregabalin 75 mg with a placebo as premedication for post-operative analgesia in patients posted for open Appendicectomy under regional anesthesia.

Methods: A randomized controlled trial was conducted on 90 patients undergoing open Appendicectomy under regional anesthesia. The patients were divided in two groups of 45 each: group C (placebo); group P (75 mg pregabalin), drug was administered orally 60 minutes before surgery. The Ramsay sedation scale (RSS) was used for assessment of sedation and the visual analog scale (VAS) was used to determine pain at rest and cough, along with assessment of time required for rescue analgesics on the first post-operative day.

Results: The RSS scores were significantly higher in groups P as compared to the controls (p<0.001). Postoperative VAS scores for pain both at rest and on cough were significantly reduced in group P (p<0.001). Rescue analgesic consumption decreased significantly in group P (p<0.001). The time at which first dose of rescue analgesia administered was 4.50±3.04 hours in group C, 10.90±5.37 hours in group P (p<0.001).

Conclusions: Pregabalin as premedication prolong the postoperative analgesia in addition to decreased consumption of analgesics.

Metrics

Metrics Loading ...

References

Dolin S, Cashman J. Tolerability of acute post-operative pain management: nausea, vomiting, sedation, pruritus, and urinary retention. Evidences from published data. Br J Anaesth. 2005;95(5):584-91.

Schug SA, Zech D, Grond S. Adverse effects of systemic opioid analgesics Drug Saf. 1992;7:200-13.

Ofman JJ, MacLean CH, Straus WL, Morton SC, Berger ML, Roth EA, et al. A meta analysis of severe upper gastrointestinal complications of nonsteroidal antiinflammatory drugs. J Rheumatol. 2002;29:804-12.

Ben-Menachem E. Pregabalin pharmacology and its relevance to clinical practice. Epilepsia. 2004;45(6):13-8.

Imani F, Rahimzadeh P. Gabapentinoids: gabapentin and pregabalin for postoperative pain management. Anesth Pain Med. 2012;2(2):52-3.

Tiippana EM, Hamunen K, Kontinen VK, Kalso E. Do surgical patients benefit from perioperative gabapentin/pregabalin? A systematic review of efficacy and safety. Anesth Analg. 2007;104(6):1545-56.

Kohli M, Murali T, Gupta R, Khan P, Bogra J. Optimization of subarachanoid block by oral pregabalin for hysterectomy. J Anaesthesiol Clin Pharmacol. 2011;27(1):101-5.

Mao Y, Wu L, Ding W. The efficacy of preoperative administration of gabapentin/ pregabalin in improving pain after total hip arthroplasty: a meta-analysis. BMC Musculoskelet Disord. 2016;17(1):373.

Jokela R, Ahonen J, Tallgren M, Haanpaa M, Korttila K. Premedication with pregabalin 75 or 150 mg with ibuprofen to control pain after day-case gynaecological laparoscopic surgery. Br J Anaesth. 2008;100(6):834-40.

Julius D, Basbaum AI. Molecular mechanisms of nociception. Nature. 2001;413(6852):203-10.

Werner MU, Mjobo HN, Nielsen PR, Rudin A. Prediction of postoperative pain: a systematic review of predictive experimental pain studies. Anesthesiology. 2010;112(6):1494-502.

Hurley RW, Wu CL. Acute Postoperative pain. In: Miller RD, Eriksson LI, Fleisher LA, Wiener-Kronish JP, Young WL, eds. Miller’s Anesthesia. 7th ed. USA: Churchill Livingston Elsevier; 2010:2757-2782.

Vadivelu N, Mitra S, Narayan D. Recent advances in postoperative pain management. Yale J Biol Med. 2010;83(1):11-25

Bandelow B, Wedekind D, Leon T. Pregabalin for the treatment of generalized anxiety disorder: a novel pharmacologic intervention. Expert Rev Neurother. 2007;7(7):769-81.

White PF, Tufanogullari B, Taylor J, Klein K. The effect of pregabalin on preoperative anxiety and sedation levels: a dose-ranging study. Anesth Analg. 2009;108(4):1140-5.

Agarwal A, Gautam S, Gupta D, Agarwal S, Singh PK, Singh U. Evaluation of a single preoperative dose of pregabalin for attenuation of postoperative pain after laparoscopic cholecystectomy. Br J Anaesth. 2008;101(5):700-4.

Alimian M, Imani F, Faiz SH, Pournajafian A, Navadegi SF, Safari S. Effect of oral pregabalin premedication on post-operative pain in laparoscopic gastric bypass surgery. Anesth Pain Med. 2012;2(1):12-6.

Paech MJ, Goy R, Chua S, Scott K, Christmas T, Doherty DA. A randomized, placebo-controlled trial of preoperative oral pregabalin for postoperative pain relief after minor gynecological surgery. Anesth Analg. 2007;105(5):1449-53.

Ittichaikulthol W, Virankabutra T, Kunopart M, Khamhom W, Putarawuthichai P, Rungphet S. Effects of pregabalin on post operative morphine consumption and pain after abdominal hysterectomy with/without salphingo-oophorectomy: a randomized, double-blind trial. J Med Assoc Thai. 2009;92(10):1318-23.

Hu J, Huang D, Li M, Wu C, Zhang J. Effects of a single dose of preoperative pregabalin and gabapentin for acute postoperative pain: a network meta-analysis of randomized controlled trials. J Pain Res. 2018;11:2633-43.

Downloads

Published

2023-01-25

How to Cite

Bijapur, M. B., Kudligi, N. A., Moizuddin, S., Rasool, M., & K., S. A. (2023). Evaluation of efficacy of pregabalin as premedication for post-operative analgesia in open appendicectomy. International Journal of Research in Medical Sciences, 11(2), 617–621. https://doi.org/10.18203/2320-6012.ijrms20230174

Issue

Section

Original Research Articles