A Comparative Study Between Oral Pregabalin and Gabapentin in Prolongation of Postoperative Pain Relief after Spinal Anaesthesia

Abstract

Background: Management of pain and its complications in postoperative period still a major challenge. Generally,the pathophysiology and treatment of postoperative pain and neuropathic pain have been considered as separateand distinct, though, there is considerable overlap in their pathophysiology.Materials & Methods: The present study was designed as randomized, double blinded, parallel group, open labeltrial to compare the efficacy of pregabalin and gabapentin as preemptive analgesics in surgery below umbilicusunder spinal anaesthesia. This study was conducted under the Department of Anesthesiology, in the R.G. KarMedical College & Hospital, Kolkata. Sixty two patients, aged between 20-50 yrs, ASA grade I and II, scheduled toundergo infra umbilical surgery, were randomly divided into 2 groups. In group G (n=31) they received 1200 mggabapentin, in group P (n=31) they received 300 mg pregabalin capsules, orally with sips of water, 1 hour beforethe induction of anesthesia. Routine monitoring in the form of NIBP, Pulse oxymetry and ECG were instituted onarrival in Operation Theatre. All patients were preloaded with 10 ml/kg lactated Ringer’s solution before beingadministered spinal anesthesia. Spinal anesthesia was instituted with 3 ml of 0.5% bupivacaine (15 mg) at L3 – L4/ L4 - L5 level.Results: All the groups were comparable in respect to demographic data, ASA physical status, the mean durationof surgery and the type of surgeries performed between them. In the 24 hrs of post-perative period the mean VASscores at rest of Groups P was always significantly lower than those of Group G. The time to first dose of rescueanalgesic was compared between the groups, as in Group G (gabapentin group) rescue analgesic was given after9.41±1.84 hrs, while in Group P (pregabalin group) rescue analgesic was required after 15.38±3.52 hrs. Hence, ascomparison of pregabalin and gabapentin could be made for these parameters, and it was possible to come to aconclusion as the superiority of pregabalin over gabapentin.Conclusion: In conclusion, a single oral dose of pregabalin given preoperatively provides better postoperative pain control and decreases postoperative rescue analgesic consumption compared to single dose of gabapentin,based on lower mean VAS scores at rest.