Preemptive Analgesia with Pregabalin: It’s Effect on Postoperative Analgesia after Abdominal Hysterectomy

Abstract

Background: Preemptive administration of single dose pregabalin reduces postoperative narcotic analgesicconsumption after abdominal hysterectomy under sub-arachnoid block.

Objectives: The present study was designed to evaluate the effect of pregabalin as a preemptive agent toreduce postoperative pain.

Methodology: This randomized double-blind placebo-controlled clinical trial was conducted in theDepartment of Anesthesia, Analgesia and Intensive Care Medicine at Banghabandhu Sheikh Mujib MedicalUniversity, Dhaka from July 2010 to June 2012 for a period of two years. Women aged between 40 to 60years scheduled for abdominal hysterectomy under sub-arachnoid block were selected as study population.A total of one hundred and twenty women were randomly allocated into two equal groups by cardsampling. 120 cards, 60 for each group were prepared by another person who was not aware of the study.Group A was known as study group who were received 300mg oral pregabalin one hour before performanceof SAB and group B was known as control group who were received matching placebo one hour beforeSAB.Pain in the postoperative period was assessed on visual analogue scale and managed with PCAusing morphine. Patients were visited by the investigators at ½, 1, 2, 4, 12, and 24 h after operation. Ateach visit, outcomes were measured in the following order: heart rate, mean arterial pressure, respiratoryrate, SpO2, and VAS pain score, sedation score, and any side effects which would develop. Finally, totalamount of morphine administered in 24 hour was recorded. The time since spinal anaesthesia to firstdose of analgesic was also recorded.

Result: The mean 24hrs morphine consumption was 13.3 (±1.5) mg in Group-A, whereas in Group-B was29.1(±2.1) mg. The Group-A showed a significant reduction in morphine consumption then the Group-B(P<0.001). The time interval of first dose of analgesic was 5.2(±0.4) hrs in the Group-A, whereas in theGroup-B was 2.3(±0.2) hrs.The difference was significant (P<0.05).It was seen that side effects like respiratorydepression more in Group-B, dizziness and somnolence was more in Group-A than Group-B.Sedationscore was higher in Group-A than Group-B. Incedence of nausea/vomotting was same in both groups.

Conclusion: It is demonstrated that preemptive use of Pregabalin led to significant reduction in narcoticanalgesic requirement and thereby a significant reduction in morphine related side effects. Beside this,pregabalin caused increased levels of sedation which may be beneficial for certain patients in earlypostoperative periods.

JBSA 2017; 30(2): 66-74