Perioperative Anxiolytic and Analgesic Effects of Pregabalin in Vitreo-Retinal Surgery: A Randomized, Double-blind Study

Abstract

Objectives: This study was done to examine the effect of a single, one-time pregabalin dose on postoperative pain, anxiety, and analgesic consumption after vitrectomy performed under the peribulbar block and to assess the satisfaction of the patients as well as the surgeons. Methods: This randomized, double-blinded, placebo-controlled trial was conducted at Magrabi Eye, ENT and Dental Center, Doha, Qatar on 58 adult patients aged 37 - 75 years, who met status I and II of the American Society of Anesthesiologists (ASA) and scheduled for elective vitrectomy, under the peribulbar block (PB). Of the total participants, 30 cases were randomized to receive pregabalin, while the remaining received placebo 90 minutes before surgery. Pain was assessed using a Verbal Analog Scale (VAS) score, and the levels of anxiety were gauged by verbal anxiety score. Results: Patients who received pregabalin had a significantly higher sedation score (3 ± 0 vs. & 2 ± 0.65; P < 0.05), and a significantly less anxiety score (3 ± 1.3 vs. 5 ± 1.6; P < 0.001) compared to the control group. During needle insertion for PB, patients in the pregabalin group experienced less pain compared to the control group (32 ± 15 vs. 44 ± 15; P < 0.05). Pregabalin group showed a significantly higher cooperation rate and patient satisfaction scores (3.2 ± 0.7 and 3.8 ± 0.4, respectively), compared to the placebo group (2.8 ± 0.7 and 3.4 ± 0.5, respectively). The placebo group required intraoperative midazolam more in comparison to the pregabalin group (19 vs. 5; P < 0.001). Moreover, the need for postoperative analgesia was more in the placebo group two hours postoperatively. Conclusions: Pregabalin is a potent premedication in controlling post-surgical pain and anxiety in patients undergoing vitrectomy under the PB.

Intelligent game between intubation and stress regarding hemodynamic and hormonal changes

“…The previous data are on line with our results, which revealed that dexmedetomidine delayed recovery compared to fentanyl.Dexmedetomidine being an α-2 antagonist can decrease both heart rate and systolic blood pressure, Urooj et al, (2024) reported hypotension in ve patients and bradycardia in two patients out of (90) patients in their study and added that clinically patients did not need treatment. The previous work goes hand in hand with our ndings Whoever, Jain et al,(2015) reported that dexmedetomidine infusion within 10 minutes showed no difference with fentanyl regarding attenuation of sympathetic response during endotracheal intubation.present study is online with those previous study which showed that dexmedetomidine attenuate intubation stress regarding blood sugar and hormones regulate its level mainly cortisone, norepinephrine and insulin Oriby et al, (2023). reported that dexmedetomidine was superior on fentanyl-Midazolam combination regarding attenuation of hemodynamic response from baseline uptill the end of surgery.…”

“…reported that dexmedetomidine was superior on fentanyl-Midazolam combination regarding attenuation of hemodynamic response from baseline uptill the end of surgery. In agreement withOriby et al, (2023),Basantwani et al, (2016) andGhomeishi et al, (2021), concluded that Dexmedetomidine decrease heart rate and blood pressure by inhibiting both cortisone and norepinephrine. The previous data may support our results regarding attenuation of haemodynamic response for dexmedetomidine compared to fentanyl.…”

Vitreoretinal Surgery Under Sub-Tenon’s Block and Conscious Sedation in a Patient with Brugada Syndrome: A Case Report and Literature Review

“…The choice of anesthesia depends on several factors, including patient suitability (medical condition), surgical procedures, and preference of the patient, surgeon, or anesthesiologist. There is no clear evidence on which type of anesthesia is best in reducing harm and providing the best surgical conditions and optimal outcomes for patients (13)(14)(15)(16)(17). Our patient preferred RA over GA.…”

The anxiolytic effects of preoperative administration of pregabalin in comparison to diazepam and placebo

“…A recent www.nature.com/scientificreports/ systematic review of 12 high quality randomized controlled trials concluded that preoperative administration of a single dose pregabalin 150 mg appears to be effective for reducing anxiety significantly 20 . For minor procedures performed under local anesthesia, Elrashidy et al 38 found that patients scheduled for vitreo-retinal surgery who received preoperative pregabalin demonstrated less anxiety in comparison to placebo. Eskandarian et al 39 premedicated 4-6 years old children scheduled for dental treatment with pregabalin 75 mg and found that it reduced anxiety score significantly.…”