Post-operative analgesic and opioid-sparing effect of a single dose pre-operative oral pregabalin in gynaecological surgeries
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Date
2022
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Publisher
West African College of Surgeons
Abstract
Background: Post-operative pain treatment is a major challenge in our environment. Opioids may
cause respiratory depression post-operatively. Therefore, any combination of opioid and non-opioid
analgesics that provides quality post-operative pain control and reduces opioid consumption with
its attendant side effects will be highly desirable. Objectives: The aim of this article is to evaluate
analgesic benefits and opioid-sparing effects of pre-operative oral pregabalin in patients who
undergo abdominal gynaecological surgeries. Materials and Methods: A prospective randomized
double-blind placebo-controlled study is carried out at University of Ilorin Teaching Hospital,
Kwara State, Nigeria. Eighty-two patients scheduled for gynaecological surgeries were randomized
into two equal groups. The patients in the control and study groups received a placebo drug and
oral pregabalin 150 mg, respectively, 1 h before induction of general anaesthesia. Post-operative
pain intensity using a five-point Verbal Rating Scale, time to first request for analgesia, and 24 h
post-operative pethidine consumptions were assessed. Mean values were compared using Student’s
t-test. Categorical data were compared with the χ2 test. Level of significance was set at 5% (0.05)
and power of the study was 80%. Results: Demographic characteristics were comparable between
the two groups. The median pain score was 0–2 (no pain–moderate pain) throughout the study.
Post-operative static and dynamic pain scores at 1, 4, and 12 h were significantly higher in the
placebo group (<0.001). Twenty-four hours post-operatively, there were no significant differences
in static and dynamic pain scores between the two groups (P=0.131 and P=0.384, respectively).
Time to first analgesic requirement and total pethidine consumed within 24 h post-operative were
47 ± 19 vs. 258 ± 137 min (P=0.001) and 326.19 ± 62.70 vs. 192.86 ± 55.84 mg (P=0.001) in the control
and study groups, respectively. The pre-operative use of pregabalin reduced post-operative opioid
requirement by 40.9% in the study group. Nausea and vomiting were more common in the placebo
group, whereas dizziness, blurring of vision, and sedation were more common in the pregabalin
group. Conclusion: A single pre-operative dose of 150 mg oral pregabalin had significantly greater
analgesic effects compared with placebo and reduced post-operative opioid requirements in patients
undergoing myomectomy or total abdominal hysterectomy. It should be considered an adjuvant in
multimodal pain management regimens following gynaecological surgeries
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Keywords
Gynaecological surgeries, multimodal analgesia, postoperative pain, pregabalin
Citation
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