Comparative study between paracetamol versus paracetamol and pregabalin combination for postoperative analgesia in hip surgeries

Hassab, A R M; Fawzy, Hazem Mohammed Abdelrahman; Elfawal, Sanaa M; Kamaleldin, D M

doi:10.1093/qjmed/hcaa039.040

Cited by 3 publications

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“…Transduction process used NSAIDs, the transmission process used local anesthesia, and the modulation process used opioids and gabapentinoids. With this multimodal approach, the dose of each drug is lower, with a more optimal analgesia effect [10]. Pregabalin (3-isobutyl gamma) is a new synthetic molecule that is an analog of GABA, which is an inhibitor of neurotransmitters, such as gabapentin, which can act as an inhibitor of neuronal hyperexcitability.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Pregabalin Levels on Pain and Substance P Level Post-Cesarean Section

Gaus

Harahap

Ahmad

et al. 2023

Open Access Maced J Med Sci

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BACKGROUND: Post-operative pain is a very important problem faced by post-operative patients. Antihyperalgesia is caused by the inhibition of the neurotransmitter glutamate and substance P (SP) by pregabalin. This study aimed to compare the effect of preventive administration of 50 mg oral pregabalin and 1 g paracetamol with 75 mg oral pregabalin and 1 g intravenous paracetamol on Numeric Rating Scale (NRS) scores and SP levels after cesarean section with spinal anesthesia. AIM: The objective of the study was to compare the effect of preventive administration of 50 mg oral pregabalin and 1 g paracetamol with 75 mg oral pregabalin and 1 g intravenous paracetamol on NRS scores and SP levels after cesarean section with spinal anesthesia. METHODS: This study used a double-blind randomized trial design. Samples were selected randomly and consecutively from the entire population that met the inclusion criteria. There were a total of 30 samples. SP levels were measured 2 h before cesarean section. The study drug was administered by mouth with a sip of water 1 h before the expected time of the surgical incision. SP levels were checked at the 4th h (SP 1) and 6th h (SP 2) postoperatively. The assessment of the degree of pain using the NRS was carried out at 2 h, 4 h, 6 h, 12 h, and 24 h postoperatively. This study used the Mann–Whitney U-test to compare both the levels of SP and NRS between the two groups. RESULTS: The results of this study showed that there was a significant difference in the NRS scores between the 50 mg and 75 mg pregabalin groups (p < 0.05). In the 75 mg pregabalin group, the NRS scores were lower than in the 50 mg pregabalin group in patients undergoing CS surgery under spinal anesthesia. There was a significant difference in SP levels between the 50 mg and 75 mg pregabalin groups (p < 0.05). SP levels in the 50 mg pregabalin group increased at 4 h and 6 h postoperatively, while in the 75 mg pregabalin group, it tended to decrease at 4 h and 6 h postoperatively. CONCLUSION: The quiescent and mobile NRS scores in the 75 mg pregabalin group were lower than the 50 mg pregabalin group with a combination of 1 g intravenous paracetamol after SC surgery. SP levels in the 75 mg pregabalin group decreased compared to the 50 mg pregabalin group with a 1 g intravenous paracetamol combination which experienced an increase after CS surgery. Pregabalin 75 mg is recommended for preventive use in CS surgery.

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Section: Discussionmentioning

confidence: 99%

The Effect of Pregabalin Levels on Pain and Substance P Level Post-Cesarean Section

Gaus

Harahap

Ahmad

et al. 2023

Open Access Maced J Med Sci

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“…[35][36][37][38] Analgesic pregabalin alone or with acetaminophen and tramadol showed no AE with none to moderate pain. Rare reports are available for this combination which showed better pain control with AEs like somnolence, dizziness, and blurred vision [39].…”

Section: Discussionmentioning

confidence: 99%

Optimal and Safe Pain Management Approach in Ankle and Hindfoot Fractures: Improving Practitioner Decision

Ahmad,

Muhammad,

Mohib

et al. 2023

Preprint

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BackgroundOver or sub-optimal analgesic treatment leads to undesired consequences and patient dissatisfaction. The study aims to assess the sub-optimal or optimal pain relief and safety of routinely prescribed oral analgesic(s) at discharge and 1-week post-discharge in ankle and foot fracture surgeries.MethodsThe ongoing prospective cohort study data on 54 ankle and hindfoot trauma fracture adult patients enrolled between June 2022 to July 2023 was analyzed. Post-surgery oral analgesics prescribed at hospital discharge and 1-week follow-up were stratified for assessing adverse events and pain (Visual Analogue Scale) at 1- and 2 weeks post-discharge. The relationship of age, gender, and comorbidity was analyzed by multiple logistic regression for adverse events and multiple linear regression for pain score.ResultsMedian pain scores at 1- and 2-week follow-ups were 3.2 (IQR=3.0) and 2 (IQR=2.0) respectively. Combinations of tramadol, acetaminophen with naproxen or diclofenac or orphenadrine; and naproxen, pregabalin, with acetaminophen seemed toxic with sub-optimal pain control. Similar results were for celecoxib combined with pregabalin and etoricoxib combined with diclofenac or tramadol. Acetaminophen alone was safe but occasionally showed intolerance. Etoricoxib or diclofenac alone or with acetaminophen was safe and showed better pain control in this cohort. A regression model was non-significant for a relationship between covariates and pain scores or adverse events.ConclusionCurrent data suggests that certain oral analgesics or their combinations are harmful with sub-optimal pain control while some are safe and effective. Choosing suitable analgesics or their combinations in specific fractures might reduce patient harm with optimal pain management.

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“…7 Penelitian lainnya tahun 2020 mengevaluasi pemberian pregabalin dan kombinasi pregabalin dengan paracetamol 1 g intravena pada operasi pinggul dengan anestesi spinal didapatkan kombinasi parasetamol dan pregabalin sebagai multimodal analgesia pascabedah lebih baik daripada parasetamol saja yang dilihat pada penurunan skor nyeri dan penggunaan opioid tanpa efek signifikan pada hemodinamik. 8 Penelitian-penelitian tersebut di atas merupakan dasar dari penelitian ini, yaitu mengenai perbandingan kombinasi pregabalin oral 50 mg dan parasetamol 1 g intravena dengan pregabalin oral 75 mg dan parasetamol 1 g intravena terhadap derajat nyeri dan rescue analgesia pascabedah SC.…”

Section: Pendahuluanunclassified

“…Hal ini sesuai dengan penelitian sebelumnya tahun 2020, dimana didapatkan pemberian pregabalin 300 mg prabedah dilanjutkan 12 jam kemudian kombinasi parasetamol 1 g intravena sebagai analgesia multimodal lebih baik daripada parasetamol saja dengan menurunkan skor VAS dan konsumsi opioid pascabedah pinggul dengan anestesi spinal. 8 Penelitian lainnya tahun 2019, bahwa pemberian pregabalin 150 mg 1 jam sebelum operasi dan 12 jam setelah dosis inisial, menurunkan NRS gerak pasif fleksi lutut pada 24 jam dan 36 jam pasca pembedahan rekonstruksi ACL (Anterior Cruciate Ligament). 9 Penelitian lainnya tahun 2016 yang mengevaluasi pemberian pregabalin 300 mg oral 1 jam prabedah dibandingkan 150 mg pada operasi seksio sesarea didapatkan penurunan skor nyeri pascabedah dan menurunkan kebutuhan morfin pascabedah.…”

Section: Pembahasanunclassified

Perbandingan antara Pregabalin 50 mg dengan 75 mg terhadap Derajat Nyeri dan Rescue Analgesia Pascabedah Seksio Sesarea

Harahap¹,

Gaus²,

Ahmad³

et al. 2022

JAOI

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Latar Belakang: Nyeri pascabedah yang tidak ditangani dengan baik dapat menyebabkan konsekuensi fisiologis dan psikologis pada wanita yang menjalani seksio sesarea (SC). Pregabalin menjadi pilihan preventif analgesia untuk mengurangi nyeri neuropatik, inflamasi, iritasi jaringan, dan nyeri pascabedah SC.Tujuan: membandingkan efek pemberian pregabalin 50 mg dengan 75 mg kombinasi parasetamol 1 g terhadap skor numerical rating scale (NRS) dan rescue analgesia SC. Subjek dan Metode: Penelitian ini menggunakan pendekatan uji klinis acak tersamar ganda. Sampel terdiri atas 2 kelompok yakni P1 (kelompok yang mendapatkan pregabalin 50 mg/oral dan parasetamol 1 g intravena 1 jam prabedah) dan P2 (kelompok yang mendapatkan pregabalin 75 mg/oral dan parasetamol 1 g intravena 1 jam prabedah) dengan jumlah sampel masing-masing 15 orang. Data dianalisis menggunakan uji statistik Mann Whitney dengan tingkat kemaknaan α=0,05. Hasil: NRS diam dan gerak pada jam ke 2, 4, 6 dan 12 pascabedah SC pada kelompok P2 lebih rendah dibandingkan kelompok P1 dengan nilai p<0,05. Kelompok P1 lebih banyak mendapatkan rescue analgesia dibandingkan kelompok P2 dengan nilai p<0,05.Simpulan: Skor NRS diam, gerak, dan rescue analgesia pada kelompok pregabalin 75 mg kombinasi parasetamol 1 g lebih rendah dibandingkan kelompok pregabalin 50 mg kombinasi parasetamol 1 g pascabedah SC.

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Comparative study between paracetamol versus paracetamol and pregabalin combination for postoperative analgesia in hip surgeries

Cited by 3 publications

References 0 publications

The Effect of Pregabalin Levels on Pain and Substance P Level Post-Cesarean Section

The Effect of Pregabalin Levels on Pain and Substance P Level Post-Cesarean Section

Optimal and Safe Pain Management Approach in Ankle and Hindfoot Fractures: Improving Practitioner Decision

Perbandingan antara Pregabalin 50 mg dengan 75 mg terhadap Derajat Nyeri dan Rescue Analgesia Pascabedah Seksio Sesarea

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