POST-OPERATIVE ANALGESIC AND OPIOID-SPARING EFFECT OF A SINGLE DOSE PRE-OPERATIVE ORAL PREGABALIN IN GYNAECOLOGICAL SURGERIES

Adegboye K.A*, Kolawole I.K, Bolaji B.O, Suleiman Z.A, Adegboye M.B.
Department of Anaesthesia, University of Ilorin Teaching Hospital, Ilorin, Kwara State, Nigeria

Corresponding author: Dr. K. Adewale Adegboye Email: qasimwale@yahoo.com
Source(s) of support: University of Ilorin Teaching Hospital, Ilorin, Kwara State, Nigeria.
Conflict of interest Interest: Nil

ABSTRACT

Aim: Postoperative pain treatment is a major challenge in our environment. Opioids may cause respiratory depression postoperatively. Therefore, any combination of opioid and non-opioid analgesics that provides quality postoperative pain control and reduces opioid consumption with its attendant side effects will be highly desirable.

Objective: Evaluation of analgesic benefits and opioid-sparing effects of preoperative oral pregabalin in patients who undergo abdominal gynaecological surgeries.

Methodology: A prospective randomized double-blind placebo controlled study carried out at University of Ilorin Teaching Hospital, Kwara State. 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 150mg respectively one hour before induction of general anaesthesia. Postoperative pain intensity using a five-point Verbal Rating Scale (VRS), time to first request for analgesia, and 24 hours postoperative pethidine consumptions were assessed. Mean values were compared using the student’s t-test. Categorical data were compared with the chi-square 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 to 2 (no pain – moderate pain) throughout the study. Post-operative static and dynamic pain scores at 1, 4 and 12 hours 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 hours postoperative were 47±19 vs 258±137mins (p=0.001) and 326.19±62.70mg vs 192.86±55.84mg (p=0.001) in the control and study groups respectively. The preoperative use of pregabalin reduced postoperative opioid requirement by 40.9% in the study group. Nausea and vomiting were more common in the placebo group while dizziness, blurring of vision and sedation were more common in the pregabalin group.

Conclusion: A single preoperative dose of 150mg oral pregabalin had significantly greater analgesic effects compared to 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.

Key words: Postoperative pain, Multimodal analgesia, Gynaecological surgeries, Pregabalin.