Figure - available via license: Creative Commons Attribution-NonCommercial-ShareAlike 3.0 Unported
Content may be subject to copyright.
Source publication
Post-operative pain is one of the problems, wherein lack of control on it has many side-effects such as tachycardia, hypertension, myocardial ischemia, decreased alveolar ventilation, and poor wound healing.
In this study, we evaluated the pre-operative administration of pregabalin sufficiency and security in relieving post-operative pain after low...
Similar publications
Endotracheal extubation is associated with cardiovascular and airway responses leading to tachycardia, hypertension, arrhythmias, myocardial ischemia, coughing, agitation, bronchospasm, increased bleeding, raised intracranial and intraocular pressure which may be life threatening especially in vulnerable patients. Dexmedetomidine, a highly selectiv...
Citations
... In study done by Akhavnakbari et al, on patients undergoing lower limb orthopedic surgery; it was found that pre-operative oral pregabalin (150mg) was significantly effective in decreasing the post-operative VAS scores and total analgesia consumption as compared to the placebo group; which was similar to the findings of our study. 32 In a study done by Turan et al, on patients undergoing spinal surgeries; it was found that pre-operative oral gabapentin was significantly effective in decreasing the early postoperative (less than 4 hours) VAS scores and total analgesia consumption as compared to the placebo group; which was similar to our study's finding. (33 Yilmaz et al, in their study, found pregabalin and gabapentin to be equally effective in controlling neuropathic pain in patients suffering from spinal cord injury. ...
Background: Post-operative pain in spine surgery, whether neuropathic or nociceptive, presents a significant challenge for both surgeons and patients. Previous research has demonstrated the effectiveness of pre-operative oral gabapentinoids in reducing postoperative pain, extending the time to first rescue analgesia, and diminishing overall analgesic requirements. Methods: This study involved 120 patients undergoing lumbar discectomy for disc herniation. They were randomly assigned to receive pre-operative oral pregabalin, gabapentin, or a placebo, along with IV paracetamol as preemptive analgesia. The study assessed their efficacy through post-operative pain scores (VAS), and sedation scores (Ramsay sedation score) at various intervals, time to first rescue analgesia, and total analgesia consumption. Results: No significant differences were found in demographic variables, surgical levels, or duration among the groups. The placebo group had the shortest time to first rescue analgesia, while the pregabalin group showed the longest, with a notable difference. Across most time frames, the pregabalin group reported the lowest mean postoperative VAS scores, whereas the placebo group had the highest. Initial variations in sedation scores converged in later time frames, with the placebo group consistently recording the lowest scores. Total rescue analgesia (tramadol) in the initial 24 hours was highest in the placebo group, followed by the gabapentin group, and lowest in the pregabalin group, with no significant variance. Conclusions: This study affirms the superiority of pre-operative oral pregabalin with IV paracetamol. It effectively prolongs the time to first rescue analgesia and reduces overall analgesic consumption post-lumbar spine surgery, compared to pre-operative oral gabapentin with IV paracetamol.
... IV acetaminophen is considered the nonopioid analgesic of choice for mild-to-moderate pain. [11] Moreover, an randomized controlled trial evaluating different doses of paracetamol added to lidocaine for Bier's block in patients undergoing hand surgery confirmed that the paracetamol adjuvant could improve the quality of IV regional anesthesia without any side effects. [12,13] We found in literature, some studies have evaluated the efficacy of magnesium sulfate, tramadol, paracetamol, and midazolam in combination with lidocaine. ...
Background:
Intravenous (IV) regional anesthesia is an easy, safe, reliable, and efficient option for inducing anesthesia during surgeries but with tourniquet-related pain. This study aimed to evaluate midazolam, paracetamol, tramadol, and magnesium sulfate administration as adjuvants with ropivacaine on pain relief and hemodynamic changes in IV regional anesthesia.
Methods:
A randomized, double-blind, placebo-controlled trial was conducted in subjects undergoing forearm surgery with IV regional anesthesia. The block randomization method was used to assign eligible participants to each of five study groups. Hemodynamic parameters were assessed before applying the tourniquet, at prespecified time points (5, 10, 15, and 20 min), then and every subsequent 10 min until surgery completion. A Visual Analog Scale was used to assess pain severity at baseline followed by every 15 min until completion of the surgery, and after tourniquet deflation every 30 min to 2 h, and at 6, 12, and 24 h postoperative. Data were analyzed using Chi-square and analysis of variance with repeated data testing.
Results:
The shortest onset and the longest duration of sensory block were observed in the tramadol group and the shortest onset of motor block in the midazolam group (P < 0.001). Pain score was estimated to be significantly lower in the tramadol group at the time of tourniquet application and release, and 15 min to 12 h after tourniquet release (P < 0.05). In addition, the lowest dose of pethidine consumption was observed in the tramadol group (P < 0.001).
Conclusion:
Tramadol appeared to be able to effectively relieve pain, shorten the onset of sensory block, prolong the duration of sensory block, and achieve the lowest consumption of pethidine.
... 5 Godrat found that preemptive pregabalin in an oral dose of 150 mg offers good postoperative analgesia in lower limb orthopedic surgeries under spinal anesthesia. 6 Furthermore, Reuben et al also showed that effective multi-modal analgesia prevents the development of chronic pain. 7 The anti-nociceptive effect of preemptive analgesia develops by preventing the development of triggering hyperplastic changes at the surgical site in response to a noxious stimulus. ...
... Postoperative pain is one of the problems which should be controlled to avoid many complications such as hypertension, tachycardia, decreased alveolar ventilation, poor wound healing and myocardial ischemia [1]. ...
Background and Aim
Surgical trauma is known to cause peripheral and central sensitization and hyperalgesia, which if untreated can cause chronic postoperative pain after surgery. The current work was conducted to evaluate the effect of preoperative pregabalin 150 mg orally on opioid consumption and acute postoperative pain in spinal fusion surgery.
Methods
Over one-year duration between 2020 and 2021, the current study was conducted. Ninety patients who were scheduled for spinal fusion surgeries (single and double levels) were recruited and randomly subdivided into two equal groups who received either pregabalin or placebo. The primary outcome was the overall amount of consumed morphine in the first 24 hours postoperatively. Secondary outcomes included VAS score at 1 hour, 2 hours, 4 hours and 24 hours postoperative, time to first rescue analgesia and vital signs including heart rate and mean arterial blood pressure intra- and postoperatively.
Results
The overall amount of morphine consumed in the first 24 hours postoperatively was significantly lower in the pregabalin group than the placebo group (P < 0.001). Pregabalin group had significantly longer time to rescue analgesia than placebo group (P < 0.001). Additionally, within the first postoperative 24 hours, VAS was significantly lower (P < 0.05) in the pregabalin group than in the placebo group.
Conclusions
A single dose of 150 mg of pregabalin preoperatively may have the ability to reduce the acute postoperative pain and opioids consumption after spinal fusion surgeries.
... Reports from literature on the effect of preoperative administered pregabalin 150mg in patients receiving intratheal bupivacaine in reducing pain scores are consistent with our findings. [13,25] When pregabalin 150mg was administered before spinal anaesthesia in our study, it showed that the patients reported low pain score in comparison with controls. Sabastian et al. [13] found that pre-emptive oral pregabalin 150mg significantly decreases the postoperative pain score. ...
... Sabastian et al. [13] found that pre-emptive oral pregabalin 150mg significantly decreases the postoperative pain score. Akhavanakbari et al. [25] in a study of sixty patients showed that 150mg dose preoperative pregabalin is a reliable method in reducing pain. ...
Background: Postoperative pain is of significant concern to patients undergoing lower limb surgery. Several pharmacological agents have been used to manage postoperative pain following lower limb orthopaedic surgery with variable results. However, only a few studies compared pregabalin and gabapentin for postoperative pain management of lower limb orthopaedic surgery. Aim: This study evaluated the postoperative analgesic effect of preoperatively administered oral gabapentin and pregabalin in lower limb orthopaedic surgery. Method: Approval for this study was obtained from the Health Research and Ethics Committee of Federal Medical Centre Owerri, Imo State, Nigeria. Written informed consent was obtained from each patient before enrolment into the study. A total of 90 patients between the ages of 18 65 years, ASA I and II physical status, scheduled for elective lower limb surgery were recruited for this study. They were randomized into three groups to receive either 300mg gabapentin in group G (n = 30), 150mg of pregabalin in group P (n=30), or placebo in group C (n=30). The pain scores, duration of analgesia, total opioid consumption, and side effects of the study drugs were assessed and documented. Data were collected and analysed using Statistical Package for Social Sciences (SPSS) version 20. A p-value of < 0.05 was considered statistically significant. Results: Ninety patients completed the study. The mean VAS score at 1st hour was significantly lower in Group P (1.33±0.48), compared with Group G (2.17±0.83) and Group C (3.67±1.61), (p < 0.01). Moreover, the mean duration of analgesia was significantly prolonged in Group P (422.00±39.934 min), compared with Group G (272.07±55.08 min) and Group C (194.27±23.22 min), p<0.01. Nevertheless, the mean total analgesic consumption was significantly higher in Group C (180.23±34.07 mg), compared to Group G (126.10±41.88 mg) and Group P (102.13±32.78 mg), p<0.01. However, the incidence of hypotension was more in Group C (20%), compared with Group P (13.3%) and Group G (10%). Conclusion: This study showed that single preoperative oral pregabalin 150mg provided prolonged duration of analgesia, reduced pain score, and reduced postoperative pethidine consumption, compared with preoperative oral gabapentin in patients that received spinal anaesthesia for lower limb orthopaedic surgery.
... In addi on, the incidence of PONV(using four-point ordinal scale),seda on (assessed using Ramsey Seda on Scale),total number of rescue analgesic (inj fentanyl 50µg) doses.Haemodynamic parameterswere recorded both intra and post-opera vely for first 24 hours. [9,10] Sta s cal analysis was done using the SPSS version 20 so ware. Standard qualita ve and quan ta ve tests were used to compare the data. ...
Background and Aims:Pain and PONV (postoperative nausea and vomiting) are common complaints in the period following surgery. A multimodal approach targeting the reduction of postoperative pain with an opioid-sparing analgesic along with an antiemetic medication would minimize opioid consumption and its associated side effects. We evaluated the efficacy of methylprednisolone 125 mg IV taken along with oral 120 mg etoricoxib on postoperative pain and PONV in patients undergoing laparoscopic surgeries
Material and methods:A prospective, randomized, double-blind study was conducted on 70 patients aged between 18 and 60 years with ASA grade 1 and 2 posted for elective laparoscopic surgeries. The test group was given a combination of methylprednisolone 125mgIV (given just before induction)& etoricoxib120mg oral (given 1 hr before surgery). (Group A, n=35) while control group received normal saline IV and a placebo per oral(Group B, n=35). Duration and quality of analgesia was assessed by visual analogue scale (VAS) score at 2,4,6,8,10,12,16,20 and 24hr as primary objective. Total dose of rescue analgesic(injection Fentanyl 50 mcg) in first 24 hours, peri-operative hemodynamic change and post op nausea vomiting (PONV) were observed as secondary objective.
Result:Demographic profiles were comparable. Duration of postoperative analgesia was significantly prolonged(p<0.05) in Group A(7.57±1.04hrs) as compared to Group B(3.05±0.5hrs). Group A showed a significant reduction in postoperative fentanyl consumption in the form of rescue analgesic(p<0.05). Group A also showed significant reduction in the incidence of PONV(p<0.05).
Conclusion:We conclude that single-dose administration of methylprednisolone IV along with oral etoricoxib has better analgesic efficacy in comparison to placebo for patients undergoing laparoscopic surgeries.
... Twenty-one randomized controlled trials from 11 countries with a total sample size of 1520 (453 for the pregabalin group, 1067 for the placebo group) were included in the current analysis ( Fig. 1) [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31]. Characteristics including the author's name, year, origin, anesthesia, and dosing regimen were extracted and are displayed in Table 1. ...
Background
To systematically review the literature and provide a comprehensive understanding of the preemptive effects of oral pregabalin on perioperative pain management in lower limb orthopedic surgery.
Method
We searched three electronic databases for randomized controlled trials comparing the results of preoperative pregabalin and placebo in patients undergoing lower limb orthopedic surgery. Data analyses were conducted using RevMan 5.4.
Results
Twenty-one randomized controlled trials met our inclusion criteria. The cumulative opioid consumption within 24 and 48 h postoperatively in the pregabalin group was significantly less than that in the placebo group. The pooled static pain intensity at all time points within the first day was significantly lower in the pregabalin group than in the placebo group. Lower dynamic pain intensity at 48 h was detected in the pregabalin group than in the placebo group. Meanwhile, pregabalin led to a lower incidence of nausea but appeared to be associated with a higher incidence of dizziness and sedation. Subgroup analyses showed that no difference was detected between subgroups stratified by dosing regimen or pregabalin dose in the results of opioid consumption, pain intensity and incidence of complications.
Conclusion
This meta-analysis supports the use of pregabalin preoperatively in patients undergoing lower limb orthopedic surgery. However, it was wary of the resulting increase in dizziness and sedation. There is no evidence to support the continued use of pregabalin postoperatively or using more than 150 mg of pregabalin per day.
Trial registration: This study was registered on 09 November 2021 with INPLASY (registration number: INPLASY2021110031).
... [12] Total number of rescue analgesic (diclofenac 75mg intramuscular ) doses, hemodynamic parameters, sedation (assessed using Ramsey Sedation Scale), side effects like nausea, vomiting and dizziness were recorded both intra and postoperatively for first 24 hours. [13][14][15] Variables were analysed statistically and expressed as mean ± standard deviation. Categorical data was compared using Chi-square test. ...
... Studies which used higher or similar doses compared to our study found significantly lower VAS score for gabapentin or pregabalin group in comparison to placebo group. [7,13,15,17] Hence, with optimal dosing VAS score were lowered for painless recovery postoperatively. As fewer number of studies have noted mean VAS score at different interval, there is scope for future studies to note and confirm the same. ...
... Rescue analgesic dose required in first 24 hourswere lower with gabapentin (P=0.0202), a finding which correlated with similar studies [4,6,13] There was no need of opioids in either group and this was similar to observation made by Pragati Arora et al and Geetha chamanalli et al where injection diclofenac was sufficient to suffice the pain. [8,17] Limitations of our study were, assessment of visual analog scale score is subjective, single dose of gabapentin and pregabalin used does not infer the long-term benefits to the patient. ...
Background and Aims: Gabapentin and pregabalin, by
decreasing noxious stimulus induced excitatory
neurotransmitter release at central nervous system, may
attenuate central sensitization and eventually decrease
development of postoperative pain. We evaluated preemptive
analgesic efficacy of single dose of oral gabapentin 600 mg
and pregabalin 75mg for postoperative pain in patients
undergoing lower limb orthopedic surgery under spinal
anesthesia.
Material and methods: A prospective, randomized, double
blind study was conducted on 70 patients aged between 18 to
60 years with ASA grade 1 and 2 posted for lower limb surgeries
under spinal anaesthesia. Patients were allocated into Group
A and Group B receiving oral gabapentin(600mg) and oral
pregabalin (75mg) respectively 1.5 hours before surgery.
Primary objective was assessing duration and quality of
analgesia by Visual Analogue Scale (VAS) score at
2,4,6,8,10,12,16,20 and 24 hours.Secondary objective was to
assess total dose of rescue analgesic in first 24 hours, peri�operative hemodynamic change and various side effects.
Statistical Analysis used: Categorical data was compared using
Chi- square test. Quantitative parametric data was analysed
using unpaired student t-test. P value < 0.05 was considered
statistically significant.
Results: Mean duration of analgesia in Group A (10.53 ± 2.686
hours) was longer than Group B (7.943±3.199hr) (P =
0.0006).Mean number of analgesic dosesrequired in first 24
hourswere less in Group A (1.429 ± 0.5021) ascompared to
Group B (1.771±0.6897) (P = 0.0202).All patients remained
hemodynamically stable with no significant side effects noted
in either group.
Conclusion: We conclude that preemptive analgesic efficacy
of oral gabapentin 600mg is better in comparison to oral
pregabalin 75 mg for patients posted for lower limb orthopedic
surgeries under spinal anesthesia.
... It has been noted that pregabalin has been more effective in providing analgesic effects for neuropathic pain, [14,20] such as in postherpetic neuralgia [21], lower limb orthopedic surgery [22], and post-Lichtenstein herniorrhaphic pain [23]. ...
Purpose
The purpose of this study is to compare the effect of pregabalin in reducing the neuropathic pain in postoperative patients who have undergone single-level microdiscectomy for prolapsed intervertebral lumbar disc.
Methods
A randomized control clinical trial was conducted from June 2018 to April 2020 in three campuses Dr. Ziauddin University Hospital, Karachi, by two spinal surgeons. This study included 84 patients who underwent either emergency or elective microdiscectomy surgery. The patients randomized into two equal groups of 42, (group-A: pregabalin) and (group-B: placebo). Both groups also received routine analgesia along with the pregabalin and placebo capsules. In the intervention group, pregabalin was administered preoperative and postoperative defined times. The pain scores were recorded by visual analog scale (VAS) and Roland-Morris score system on the preoperative day and compared to the scores on follow-up on postoperative day seven.
Results
The pain scores were significantly better in group-A compared to group-B with similar baseline variables. The mean VAS scores of pains in group-A on postoperative day seven on follow-up were compared to VAS pain scores in group-B showing better pain control. The Roland-Morris scores were also significantly better for group-A.
Conclusions
The use of pregabalin in addition to the routine analgesia has better control of postoperative neuropathic pain in patients with single-level microdiscectomy compared to the patients who are receiving only routine analgesia. Other factors like cost, dose, side effects, and frequency should also be considered.
... It has been noted that pregabalin has been more effective in providing analgesic effects for neuropathic pain, [14,20] such as in postherpetic neuralgia [21], lower limb orthopedic surgery [22], and post-Lichtenstein herniorrhaphic pain [23]. ...
