The Effects of Pre-emptive Single Dose Oral Pregabalin on Maternal Anxiety and Stress Response to Laryngoscopic intubation During Caesarean Section

Abstract

ABSTRACT Background: Parturients scheduled to elective cesarean section usually develop higher anxiety and stress symptoms. Pregabalin decreases preoperative anxiety and intubation stress response; however, its effects on mother and newborn have not been investigated yet. The primary aim of this study was to investigate the effect of single-dose oral pregabalin on preoperative maternal anxiety, and the secondary aims were to assess its effect on attenuating the stress response to laryngoscopic intubation, maternal sedation, and neonatal clinical outcomes in parturients undergoing cesarean section. Methods: A prospective double-blind randomized-controlled clinical study. Sixty minutes before induction of anesthesia, 74 parturients scheduled for elective cesarean section under general anesthesia were randomly allocated into two groups: Group A (n = 37) received single oral pregabalin 150 mg capsule and Group B (n = 37) received oral multivitamin capsule. Results: Group A showed statistically significant lower number of parturients with moderate and high anxiety [11(29.73%) and 2(5.41%)], respectively, and increasing number of parturients with low anxiety [24(64.86%)] using STAI compared to [13(35.13%) and 14(37.84%)] for moderate and high anxiety, respectively, and [10(27.03%)] for low anxiety in group B and to basal numbers (p = 0.001). Rise in mean (heart rates and arterial blood pressures) from baseline values in both groups at 0 min (at intubation) and both groups were comparable at all measured time points (p > 0.05). Also, rising of mean serum glucose and cortisol levels at 10 min post-intubation from basal in both groups and both groups were comparable (p > 0.05). Mean APGAR scores were normal and both groups were comparable. All parturients were alert by AVPU score and no side effects were detected in both groups. Conclusion: Pre-emptive single oral 150 mg pregabalin is effective in decreasing maternal anxiety with good neonatal outcomes, but has no effect on stress response of laryngoscopic intubation during cesarean section.