Efficacy of Preemptive oral pregabalin for prolonging post-operative analgesia in modified radical mastectomies

Abstract

Background: The concept of preemptive analgesia had evolved in the recent years. Present days multimodal approach is the most preferred practice for perioperative pain relief, as no single agent is effective in inhibition of nociception without its side effects. Pregabalin originally a spasmolytic, now used as a newer anti-epileptic drug, in the management of generalized and partial epileptic seizures. Its use as a preemptive analgesic in many surgical procedures had proved promising results. Hence the aim of our study was to evaluate efficacy of preemptive pregabalin for prolonging post-operative analgesia, reducing post-operative opioid analgesic requirement and haemodynamic stability. Material and Methods: 80 patients of ASA grade I and II physical status posted for elective modified radical mastectomy were divided into 2 groups of 40 each. Group T –received pregabalin 150 mg orally 1 hour before general anaesthesia. Group C – received identical empty capsules as placebo 1 hour before general anaesthesia. Results: The postoperative VAS scores were significantly lower and duration of analgesia was longer in pregabalin group as to control group. The total analgesic consumption, PONV scores were also lower in pregabalin group. Ramsay sedation scores were slightly higher in pregabalin group but were acceptable clinically. The side effects were similar in both groups. Conclusion: Preemptive 150mg oral pregabalin reduces post-operative pain scores(VAS)significantly, provides longer duration and better quality of post-operative analgesia, reduces opioid analgesic requirement and attenuates haemodynamic response to laryngoscopy, endotracheal intubation and also extubation without increase the side effects when used in optimal doses. Keywords: Preemptive analgesia, Pregabalin, VAS scores, Hemodynamic stability, Modified radical mastectomies