Background: Although pregabalin and gabapentin have been used to control pain after spinal surgery, there is little evidence comparing their analgesic advantages to opioids. Objective: The current study aimed to assess efficacy and safety of analgesia with pregabalin versus gabapentin compared to opioids in patients undergoing elective lumbar microdiscectomy. Methods: This randomized-controlled trial included 72 patients scheduled for elective lumbar microdiscectomy. The patients were randomly allocated to three groups. Each group enrolled 24 patients who received 0.1 mg/kg of morphine intramuscularly 30 minutes before the surgery. One hour before the surgery, 150 mg of pregabalin was given orally for the pregabalin (P) group, meanwhile, in the gabapentin (G) group, 400 mg of gabapentin were given orally, and in the control (C) group, 100 micrograms of vitamin B12 were given orally. The primary outcome was the time to first rescue analgesia. The secondary outcomes were the intraoperative hemodynamics, visual analogue score, total consumption of morphine during the first postoperative 24 h, and morphine complications. Results: Groups P and G had significantly longer time to first analgesia and significantly lower total morphine consumption during the first 24 h and visual analogue scores at 10, 12, 16, 20, and 24 hours postoperatively. All groups had comparable hemodynamic parameters and postoperative complications. Conclusion:In elective lumbar microdiscectomy, preoperative administration of pregabalin provided longer time to first rescue analgesia with better acute pain control and lower total analgesic consumption compared to gabapentin and opioid analgesia.

Background: In squint and buckle surgeries, the intraoperative pain of muscle traction might not be completely prevented by local anesthetic (LA) drugs. Adding fentanyl to LA can avoid systemic opioids side effects. Objectives: The aim of the current work was to evaluate the safety and efficacy of adding fentanyl to peribulbar block to abolish or decrease muscle traction pain during squint or buckle operations. Patients and methods: This randomized clinical trial study included a total of 60 adult patients (18-65-year-old) of both genders booked for either squint or scleral buckle surgeries, attending at Research Institute of Ophthalmology, Giza, Egypt. Patients were allocated randomly into two groups (30 patients each); fentanyl group and control group. Intraoperative pain was the primary outcome, whereas secondary outcomes included the onset of complete akinesia and patient satisfaction. Results:The median pain score was 1 for both groups. Two patients of the fentanyl group and 5 patients of the control group required general anesthesia. The mean time to achieving complete akinesia was shorter in the fentanyl group with a significant statistical difference (134.2±35.8 vs. 156.3±34.7, p = 0.018). The patient satisfaction was more with fentanyl use but with no statistical significance. Conclusions: It could be concluded that fentanyl added to the local anesthesia mixture of peribulbar block in squint and scleral buckle surgeries shorten the time needed to achieve complete akinesia. However, it does not improve the intraoperative pain resulting from muscle traction. Also, it does not affect the need for general anesthesia or postoperative patient satisfaction.