Oral pregabalin premedication for attenuation of haemodynamic pressor response of airway instrumentation during general anaesthesia: A dose response study

Rastogi, Bhawna; Gupta, Kumkum; Gupta, Prashant; Agarwal, Salony; Jain, Manish; Chauhan, Himanshu

doi:10.4103/0019-5049.93344

Cited by 35 publications

(26 citation statements)

References 19 publications

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“…The results of the current study are in agreement with those of studies performed by Singh and Arora [17], Montazeri et al [18] and Rastogi et al [16], who demonstrated that the hemodynamic pressor response to airway instrumentation was attenuated by the use of oral pregabalin as a premedication. Similar results have also been reported by Salman et al [7] and Eren et al [19] who observed the a significant increase in HR and BP in the control group and atte- [12].…”

Section: Discussionsupporting

confidence: 83%

“…Similarly, Rastogi et al studied the effect of different doses of pregabalin premedication for attenuating the hemodynamic pressor response to airway instrumentation during general anesthesia [16]. They reported that the HR increased significantly immediately after laryngoscopy and intubation in all groups.…”

Section: Discussionmentioning

confidence: 99%

“…It has been alleged to possess anxiolytic, analgesic, and anticonvulsant properties. Recent studies have found that premedication with oral pregabalin could produce dose-dependent reductions in acute H. El-Hussiny et al Open Journal of Anesthesiology (state) anxiety and increases in sedation (sleepiness) before the induction of general anesthesia; however few studies on the cardiovascular properties of pregabalin in patients undergoing surgery are present in the literature [5] [6]. Thus, this study compared the efficacy and safety of two different doses (150 mg and 300 mg respectively) of oral pregabalin premedication on attenuation of the hemodynamic pressor response to airway instrumentation and, perioperative hemodynamic stability, as well as secondary outcomes, i.e., preoperative sedation, acute postoperative pain and analgesics consumption, in patients undergoing laparoscopic cholecystectomy.…”

Section: Introductionmentioning

confidence: 99%

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Preoperative Sedation, Hemodynamic Stability during General Anesthesia and Improving Postoperative Pain: Pregabalin Is the Answer

El-Hussiny¹,

Fahmy²,

Eldemrdash³

2018

OJAnes

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Background: Tracheal intubation is a noxious stimulus that tends to provoke a marked sympathetic response which is potentially deleterious in some patients. Various methods have been used to minimize and attenuate these potentially harmful responses. Aim of the study: The present study compared the efficacy and safety of two different doses (150 mg and 300 mg) of oral pregabalin premedication on attenuation of the hemodynamic pressor response to airway instrumentation, perioperative hemodynamic stability, preoperative sedation, and postoperative pain reduction. Patients and methods: This prospective, observational study consisted of 60 adult patients scheduled for laparoscopic cholecystectomy. The patients were randomized into three groups of 20 patients each. Group I (P0) received an oral placebo, group II (P150) received 150 mg of oral pregabalin and group III (P300) received 300 mg of oral pregabalin 1 h prior to induction. All patients were assessed for pre-operative sedation, perioperative hemodynamic changes, Post-operative pain and analgesic consumption. Results: Regarding the efficacy of the preoperative administration of oral pregabalin, a dose dependent attenuation in the increased in heart rate, systolic, and diastolic blood pressure, and mean arterial blood pressure resulting from laryngoscopy and intubation was observed (300 mg > 150 mg), along with a subsequent decrease in intraoperative fentanyl supplementation. On anxiolysis, patients were more comfortable and asleep in the pregabalin groups as compared with the control group, in which more patients were awake and agitated. Post-operative pain and analgesic consumption were effectively reduced by (150 mg and 300 mg) pregabalin in a dose-dependent manner. Postoperative nausea and vomiting were significantly lower with the administration of pregabalin compared with the placebo group (P < 0.008). Additionally, pregabalin increased the incidence of dizziness and visual disturbances in a dose-dependent manner. Con- clusion: Oral pregabalin premedication adequately sedated patients and attenuated the hemodynamic pressor response to airway instrumentation in a dose-dependent manner. Premedicated patients were haemodynamically stable perioperatively without recovery time prolongation or side effects, except dizziness with 300 mg of oral pregabalin. Additionally, oral pregabalin reduced postoperative pain and analgesic consumption in a dose-dependent manner.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Preoperative Sedation, Hemodynamic Stability during General Anesthesia and Improving Postoperative Pain: Pregabalin Is the Answer

El-Hussiny¹,

Fahmy²,

Eldemrdash³

2018

OJAnes

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“…Pregabalin, a gabapentinoid compound, is an antiepileptic drug that is effective for treating several kinds of pain, including neuropathic, incisional, and inflammatory pain [6], as well as anxiety [7] and provides hemodynamic stability [8]. Pregabalin also attenuates OIH in human and animal studies [9,10].…”

Section: Introductionmentioning

confidence: 99%

Effect of oral pregabalin on opioid-induced hyperalgesia in patients undergoing laparo-endoscopic single-site urologic surgery

Lee

Kim

2013

Korean J Anesthesiol

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BackgroundPregabalin is an antiepileptic drug that is effective for treating postoperative pain, neuropathic pain, anxiety, and hemodynamic instability. The aim of this study was to investigate the effect of a single preoperative dose of pregabalin in patients with opioid-induced hyperalgesia (OIH).MethodsNinety ASA I-II patients undergoing laparoendoscopic single-site urologic surgery were randomly assigned to one of the following three groups that received either pregabalin or placebo 1 h before anesthesia and an intraoperative remifentanil infusion. Group plL received placebo and 0.05 µg/kg/min remifentanil, group plH received placebo and 0.3 µg/kg/min remifentanil, and group prH received 300 mg pregabalin plus 0.3 µg/kg/min remifentanil. The primary endpoint was pain intensity upon movement 1, 6, 12, and 24 h after surgery. Secondary endpoints were the area of hyperalgesia and mechanical hyperalgesia threshold 24 h after surgery, time to first postoperative analgesic requirement, and cumulative postoperative volume of morphine administered via a patient-controlled analgesia (PCA) pump over 24 h.ResultsThe time to first postoperative analgesic requirement in group plH was significantly shorter than that in group plL. The injected PCA volume was significantly greater in group plH than that in the other two groups. Postoperative pain intensity in group plH was significantly greater than that in the other two groups at 6, 12, and 24 h after surgery. The mechanical hyperalgesia threshold and the area of hyperalgesia around the surgical incision 24 h after surgery in group plH differed significantly from those in the other two groups, which were not significantly different. Adverse effects were comparable among groups.ConclusionsHigh-dose remifentanil induced hyperalgesia, including increased pain intensity, increased area of hyperalgesia, and decreased mechanical hyperalgesia threshold. These effects were attenuated by oral administration of a single preoperative dose of pregabalin (300 mg) in patients undergoing laparo-endoscopic single-site urologic surgery.

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“…There are various studies regarding the use of pregabalin for attenuation of pressor response during laryngoscopy and intubation in normotensive patients. 7,8 However only a few trials have evaluated hemodynamic pressor response among controlled hypertensive patients. The inhibitory effects of pregabalin on membrane voltage-gated calcium channels can be the reason for its response to laryngoscopy and intubation.…”

mentioning

confidence: 99%

Use of Low Dose Pregabalin for Attenuation of Hemodynamic Response to Laryngoscopy and Intubation in Treated Hypertensive Patients

et al. 2019

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Introduction: Laryngoscopy and tracheal intubation are two powerful noxious stimuli that can be potentially deleterious specially in hypertensive patients. This study evaluated the efficacy of low dose oral pregabalin used as a premedication for attenuation of this marked sympathetic response of airway instrumentation. Materials and Methods:This was a double blind randomised study done at a tertiary level referral hospital. The trial was registered as UMIN-000037103 (https://www.umin.ac.jp/ctr/). Patients were randomly assigned into two groups. Placebo arm received multivitamin capsule and treatment arm received Cap. Pregabalin (75 mg), 60 minutes before the induction of general anesthesia. The level of preoperative sedation was assessed with the Ramsay Sedation Scale. Heart rate, systolic, diastolic and mean arterial blood pressure were monitored and recorded before and during induction, during laryngoscopy and 1, 3 and 5 minutes of intubation.Results: A total of 50 patients, 25 in each arm were enrolled. The baseline characteristics were comparable. SBP was significantly lower in the Pregabalin group than in Placebo at all the periods of recording, however, DBP and MAP decreased significantly during, after 1 and 3 minutes of laryngoscopy (p=0.001). Sedation was significantly better in the Pregabalin group with 86% in RSS 3 compared to 80% of a placebo arm in RSS2 (P <0.001). Conclusions:Premedication with a single oral dose of Pregabalin (75 mg) is effective for sedation and attenuation of hemodynamic response to direct laryngoscopy and endotracheal intubation in controlled hypertensive patients without any side effects.

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Oral pregabalin premedication for attenuation of haemodynamic pressor response of airway instrumentation during general anaesthesia: A dose response study

Cited by 35 publications

References 19 publications

Preoperative Sedation, Hemodynamic Stability during General Anesthesia and Improving Postoperative Pain: Pregabalin Is the Answer

Preoperative Sedation, Hemodynamic Stability during General Anesthesia and Improving Postoperative Pain: Pregabalin Is the Answer

Effect of oral pregabalin on opioid-induced hyperalgesia in patients undergoing laparo-endoscopic single-site urologic surgery

Use of Low Dose Pregabalin for Attenuation of Hemodynamic Response to Laryngoscopy and Intubation in Treated Hypertensive Patients

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