Pregabalin premedication - A new treatment option for hemodynamic stability during general anesthesia: A prospective study

Background: Hemodynamic responses of laryngoscopy, intubation, and pain are powerful noxious stimulus which should be attenuated by the appropriate premedication, smooth induction, and rapid intubation.

Context: The oral pregabalin may attenuate the hemodynamic pressor response with intraoperative hemodynamic stability.

Aims: The present study was designed to evaluate the clinical efficacy and safety of oral pregabalin for hemodynamic stability.

Settings and design: This is a prospective blind randomized controlled cohort observation study.

Materials and methods: The 80 adult consented patients of ASA grade I and II of either gender aged 24-54 years who met the inclusion criteria were randomized to receive oral pregabalin 150 mg or placebo capsule, given 60-75 min before surgery. Patients were premedicated with metoclopramide (10 mg), glycopyrrolate (0.2 mg), and fentanyl (1 μg/kg). Anesthesia was induced with propofol and rocuronium and maintained with isoflurane, nitrous oxide, and oxygen. Both groups were assessed for preoperative sedation and changes in heart rate and mean arterial blood pressure before and after the induction and 1, 3, 5, and 10 min after laryngoscopy and intubation, then at 5 min intervals till end of surgery along with postoperative complications.

Statistical analysis: The hemodynamic variables were analyzed by using analysis of variance (ANOVA), Student's t test, and chi square test as appropriate.

Results: Preoperative sedation was higher with pregabalin with no significant change in heart rate. The mean arterial pressure was attenuated with oral pregabalin to statistically significant value (P<0.007). The requirement of analgesic drug was reduced with no postoperative respiratory depression, nausea, or vomiting and hemodynamic parameters remained stabilized perioperatively.

Conclusions: Oral pregabalin premedication effectively leads to sedation and analgesia with successful attenuation of the adverse and deleterious hemodynamic pressor response.