Do Surgical Patients Benefit from Perioperative Gabapentin/Pregabalin? A Systematic Review of Efficacy and Safety

Tiippana, Elina; Hamunen, Katri; Kontinen, Vesa K.; Kalso, Eija

doi:10.1213/01.ane.0000261517.27532.80

Cited by 469 publications

(305 citation statements)

References 53 publications

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“…Pregabalin has analgesic, anticonvulsant, and anxiolytic effects [5,6]. Several studies have demonstrated the efficacy of oral pregabalin on post-operative analgesia and reduction of parenteral analgesics [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Dexmedetomidine Versus Oral Pregabalin to Attenuate Hemodynamic Response to Laryngoscopy and Orotracheal Intubation: A Comparative Study

Samal

Pattnaik

Swain

et al. 2017

Asian J Pharm Clin Res

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Objectives: The airway instrumentation of direct laryngoscopy and tracheal intubation is powerful noxious stimuli that should be attenuated by appropriate premedication, smooth induction, and rapid intubation. This study compared the efficacy intravenous dexmedetomidine and oral pregabalin premedication for attenuation of hemodynamic pressor response to laryngoscopy and intubation.Methods: A total of 60 patients of age group 20-50 years scheduled for elective surgeries under general anesthesia with American Society of Anesthesiologists physical Status I and II were divided into two groups each of 30. Group D received intravenous dexmedetomidine 1 mcg/kg over 10 minutes before induction, and Group P received oral pregabalin 150 mg 1 hr before intubation. Parameters observed were heart rate (HR) and mean arterial pressure (MAP) at baseline, after induction, immediately after intubation and then 5, 10, 15, and 30 minutes thereafter.Results: Attenuation of HR in group dexmedetomidine (78.12±10.0/minutes) immediately after intubation was statistically significant than group pregabalin (89.76±10.45/minutes). MAP significantly (p<0.05) decreased after intubation with dexmedetomidine. As compared to oral pregabalin, attenuation of HR and MAP was statistically significant till 30 minutes after intubation with intravenous dexmedetomidine. Conclusion:Intravenous dexmedetomidine 1 µg/kg is more effective than oral pregabalin 150 mg in attenuating hemodynamic response to laryngoscopy and orotracheal intubation.

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Section: Introductionmentioning

confidence: 99%

Dexmedetomidine Versus Oral Pregabalin to Attenuate Hemodynamic Response to Laryngoscopy and Orotracheal Intubation: A Comparative Study

Samal

Pattnaik

Swain

et al. 2017

Asian J Pharm Clin Res

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“…It also had a longer duration of analgesia than ibuprofen Stahl, [33] . In 2007 Tippana et al [34] analyzed 22 randomized, controlled trials examining the analgesic efficacy, adverse effects, and clinical value of gabapentinoids (pregabalin and gabapentin) in postoperative pain. They concluded that gabapentinoids effectively reduce postoperative pain, opioid consumption, and opioid-related side effects after surgery.…”

Section: Discussionmentioning

confidence: 99%

The Analgesic Effect of Pregabalin, a Comparative Study With Morphine

A.Shabayek

A.Mustafa

Khorshid

et al. 2014

Zagazig University Medical Journal

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Objectives: this study was designed to assess and compare the effects of pregabalin and morphine on acute thermal pain and on nerve injury associated pain (chronic neuropathic pain). Methods: 72 male albino rats were divided into two major groups: group I (acute pain group) 30 rats divided into 5 equal subgroups (1)control, (2) pregabalin 30 mg/kg, (3)morphine 0.5 mg/kg, (4) pregabalin 60 mg/kg, (5)morphine 1mg/kg, and group II(chronic pain group) 42 rats were divided into 7 equal subgroups (1)sham operated, (2)control normal, (3) control postoperative, (4) pregabalin 30mg/kg, (5) morphine 0.5 mg/kg, (6) pregabalin 60 mg/kg, (7) morphine 1mg/kg. For acute pain the reaction times, which indicate the tolerability of the animals to acute thermal pain, was measured using analgesia meter. However chronic neuropathic pain was induced in experimental animals by unilateral ligation of the sciatic nerve in the thigh. Results: The result of the present study revealed that neither 30 nor 60 mg/kg pregabalin produced any significant effects on the tolerability of rats to acute thermal pain. On the other hand, pregabalin (30 and 60 mg/kg) markedly reversed allodynia and hyperalgesia in rats subjected to sciatic nerve ligation. The effect of pregabalin 30 mg/kg was noticed after 60 minutes and persist for 90 minutes but the higher dose (60 mg/kg) produced analgesic effect all over the experiment. On the other hand morphine 0.5 and 1 mg/kg significantly increased the tolerability of normal and sciatic nerve ligated rats to thermal nociception. The analgesic effect of morphine was more significant than that of pregabalin all over the experiments. Conclusion: in contradiction to morphine, pregabalin was not effective for treatment of acute pain. Both pregabalin and morphine produced significant analgesic effect in neuropathic pain. The effect of morphine was more significant than that of pregabalin.

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“…While shown to be effective analgesics, both non-selective and COX-2 selective nonsteroidal anti-inflammatory drugs (NSAIDs) have potentially serious risks in this surgical group. 7,8 The alpha-2-delta ligand drugs, gabapentin and pregabalin, have been shown to reduce pain scores and opioid requirements and to improve postoperative pulmonary function in a number of surgical settings 9,10 To date, there have been no published reports on the use of these drugs in the setting of cardiac surgery.…”

Section: Résumémentioning

confidence: 99%

Cardiopulmonary bypass does not affect plasma concentration of preoperatively administered gabapentin

Parlow

Gilron

Milne

et al. 2010

Can J Anesth/J Can Anesth

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Purpose Drug effects can be unpredictable during cardiac surgery due to factors that may influence drug concentration, such as extracorporeal oxygenation and hemodilution. The primary aim of the current investigation was to determine whether plasma gabapentin concentration is altered by cardiopulmonary bypass (CPB). Methods Following approval from the Research Ethics Board and written informed consent, we conducted this open-label prospective cohort investigation. A convenience sample of 16 patients, who were scheduled for coronary bypass surgery, received oral gabapentin 600 mg as follows: 90 min prior to induction of anesthesia, following tracheal extubation, and then every eight hours for a total of four doses. Plasma gabapentin concentration, as well as pain and sedation scores, were documented. Results Plasma gabapentin concentrations were unaltered during CPB (31.9 ± 12.7 lmolÁL -1 prior to CPB, 35.6 ± 12.9 to 37.2 ± 9.6 lmolÁL -1 during CPB). However, using the current protocol, drug accumulation (reflected by increased drug concentrations) was observed following the third (58.2 ± 19.5 lmolÁL -1 ) and the fourth (71.9 ± 34.3 lmolÁL -1 ) doses. Pain and sedation scores and opioid requirements were comparable with those found in other studies. Conclusion Plasma gabapentin concentration is unaltered during CPB following preoperative administration.

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Do Surgical Patients Benefit from Perioperative Gabapentin/Pregabalin? A Systematic Review of Efficacy and Safety

Cited by 469 publications

References 53 publications

Dexmedetomidine Versus Oral Pregabalin to Attenuate Hemodynamic Response to Laryngoscopy and Orotracheal Intubation: A Comparative Study

Dexmedetomidine Versus Oral Pregabalin to Attenuate Hemodynamic Response to Laryngoscopy and Orotracheal Intubation: A Comparative Study

The Analgesic Effect of Pregabalin, a Comparative Study With Morphine

Cardiopulmonary bypass does not affect plasma concentration of preoperatively administered gabapentin

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