A Comparative Study of the Effect of Oral Pregabalin Versus Oral Clonidine as Premedication on Early Postoperative Pain, Sedation in Laparoscopic Hysterectomy Under General Anesthesia
Authors/Creators
- 1. Department of Anesthesiology, Pain, Palliative & Critical Care, Institute of Medical Sciences and SUM Hospital, Siksha 'O' Anusandhan deemed to be University, Bhubaneswar, Odisha, 751003
Description
Background: Premedication is the cornerstone of good anesthesia practice. Pregabalin a lipophilic (GABA) analog, a novel anti-convulsant drug and has analgesic effect. Premedication with Clonidine alpha-2 agonist abolishes the stress response to the painful surgical stimulus by inhibiting pre- and possibly the post-synaptic α-2 adrenergic receptors in the spinal cord and medulla. Thus, we aim to compare the duration of postoperative analgesia, sedation, and recovery scores with premedication with oral Pregabalin versus Clonidine during the 1st 24 hours post-surgery among the patients posted for laparoscopic hysterectomy. Materials and Methods: This study was performed on 90 patients of ASA 1, of age 35 to 65 years female posted for laparoscopic hysterectomy, assigned to either of 3 groups of 30 participants randomly. All patients have taken oral Alprazolam (0.5 mg) at night before the operation. Preoperatively, patients had taken oral Pregabalin 75 mg tablet (group A, n=30), Clonidine 150 mg tablet (group B, n=30), and oral placebo tablets in group C(n=30) 60 minutes before surgery. Patients were induced with the injection of Fentanyl, Propofol, and Vecuronium Bromide, and anesthesia was maintained with N2O and O2 gas mixture with Isoflurane. Result: It was observed that all most all patients in group A experienced mild pain up to 4 hours postoperatively with VAS score not going more than 3 on average, while 5 patients in Group B experienced moderate pain after 2 hours of surgery, and the 4-hour VAS score was 4 or more on an average. There was not much difference in modified RSS score in group A and group B just after surgery, but 1hr post-operative score was higher among group A in comparison to group B (1.83 in group A vs 2.30 in group B). Modified Aldrete score was also observed to be less in the premedicated group compared to the control (9.73 in group A vs 9.70 in group B vs 10.00 in group C). Conclusion: It was concluded that clonidine and pregabalin both provide similar pain relief and sedation in the immediate postoperative period in our study. Pregabalin 75 mg pre-emptively provides better analgesia than clonidine 150 mcg. These two drugs are good pre-emptive analgesics for surgeries under general anesthesia and can be used alternatively.
Abstract (English)
Background: Premedication is the cornerstone of good anesthesia practice. Pregabalin a lipophilic (GABA) analog, a novel anti-convulsant drug and has analgesic effect. Premedication with Clonidine alpha-2 agonist abolishes the stress response to the painful surgical stimulus by inhibiting pre- and possibly the post-synaptic α-2 adrenergic receptors in the spinal cord and medulla. Thus, we aim to compare the duration of postoperative analgesia, sedation, and recovery scores with premedication with oral Pregabalin versus Clonidine during the 1st 24 hours post-surgery among the patients posted for laparoscopic hysterectomy. Materials and Methods: This study was performed on 90 patients of ASA 1, of age 35 to 65 years female posted for laparoscopic hysterectomy, assigned to either of 3 groups of 30 participants randomly. All patients have taken oral Alprazolam (0.5 mg) at night before the operation. Preoperatively, patients had taken oral Pregabalin 75 mg tablet (group A, n=30), Clonidine 150 mg tablet (group B, n=30), and oral placebo tablets in group C(n=30) 60 minutes before surgery. Patients were induced with the injection of Fentanyl, Propofol, and Vecuronium Bromide, and anesthesia was maintained with N2O and O2 gas mixture with Isoflurane. Result: It was observed that all most all patients in group A experienced mild pain up to 4 hours postoperatively with VAS score not going more than 3 on average, while 5 patients in Group B experienced moderate pain after 2 hours of surgery, and the 4-hour VAS score was 4 or more on an average. There was not much difference in modified RSS score in group A and group B just after surgery, but 1hr post-operative score was higher among group A in comparison to group B (1.83 in group A vs 2.30 in group B). Modified Aldrete score was also observed to be less in the premedicated group compared to the control (9.73 in group A vs 9.70 in group B vs 10.00 in group C). Conclusion: It was concluded that clonidine and pregabalin both provide similar pain relief and sedation in the immediate postoperative period in our study. Pregabalin 75 mg pre-emptively provides better analgesia than clonidine 150 mcg. These two drugs are good pre-emptive analgesics for surgeries under general anesthesia and can be used alternatively.
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IJPCR,Vol15,Issue6,Article254.pdf
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Additional details
Dates
- Accepted
-
2023-05-30
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/15/IJPCR,Vol15,Issue6,Article254.pdf
- Development Status
- Active
References
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