Role of preoperative pregabalin in reducing inhalational anesthetic requirements in abdominal hysterectomy: randomized controlled trial

Minerva Anestesiol. 2020 Jan;86(1):56-63. doi: 10.23736/S0375-9393.19.13734-0. Epub 2019 Sep 13.

Abstract

Background: Preoperative oral pregabalin controls postoperative pain and decreases anesthetic requirements in total intravenous anesthesia. In this study, we hypothesized that preoperative pregabalin reduces inhaled isoflurane requirements.

Methods: We investigated the effectiveness of preoperative oral pregabalin 150 mg in women undergoing elective open total abdominal hysterectomy under general anesthesia. A prospective, randomized, double-blind, controlled study was conducted in a university hospital. The study included 50 women (18-60 yrs.), ASA I or II, admitted for abdominal hysterectomy under general anesthesia. Exclusion criteria were allergy to pregabalin; calcium channel blockers, antiepileptic drugs, antidepressant drugs, any analgesics, sedatives, or oral hypoglycemic agents. Patients were randomized into two groups; Pregabalin group received oral pregabalin 150 mg and placebo group. Main outcome measures was inhaled isoflurane requirements to maintain hemodynamics ±20% of baseline and bispectral index of 40 - 60, measured using MAQUET Flow-I anesthetic machine. Secondary outcomes were attenuation of pressor response to intubation, postoperative pain, and first time for rescue analgesia, total analgesics and adverse effects.

Results: Isoflurane consumption was significantly less in pregabalin group (7.80±1.27 mL h -1) versus (12.27±2.49 mL h-1) in the control group, (P=0.00). Better hemodynamic stability was in pregabalin group. First postoperative hour: the mean VAS Score was significantly higher in control group (7.10±1.20) compared to pregabalin group (4.50±1.70), P<0.001. More dizziness was in pregabalin group.

Conclusions: Preoperative pregabalin 150 mg, 1 h before total abdominal hysterectomy has an inhaled anesthetic-sparing effect, maintain hemodynamics and optimizes postoperative analgesia.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Analgesics / therapeutic use*
  • Anesthesia, Inhalation*
  • Anesthetics, Inhalation / administration & dosage*
  • Consciousness Monitors
  • Double-Blind Method
  • Female
  • Hemodynamics / drug effects
  • Humans
  • Hysterectomy / methods*
  • Isoflurane / administration & dosage
  • Middle Aged
  • Pain Measurement
  • Pain, Postoperative / epidemiology
  • Postoperative Nausea and Vomiting / epidemiology
  • Pregabalin / therapeutic use*
  • Prospective Studies
  • Treatment Outcome

Substances

  • Analgesics
  • Anesthetics, Inhalation
  • Pregabalin
  • Isoflurane