Study of Attenuation of Cardiovascular Response during Laryngoscopy and Intubation Using Two Different Doses of Pregabalin as Premedication in Controlled Hypertensive Patients- A RCT

Meena, Rajesh Kumar; Meena, Kavita; Prakash, S.

doi:10.4172/2155-6148.1000607

Cited by 7 publications

(6 citation statements)

References 26 publications

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“…Although the HR increase was not completely attenuated by pregabalin, the drug obviously mitigated the HR after laryngoscopy and intubation, which is in agreement with findings reported by Meena et al showing no significant difference in the HR before and after premedication [15]. Immediately after laryngoscopy and intubation, the HR increased significantly in all groups, but the increase was smallest in group III (PG300); as such, the heart HR was not completely attenuated by pregabalin but was definitely mitigated after laryngoscopy.…”

Section: Discussionsupporting

confidence: 82%

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: 82%

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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“…The above facts explain that 150 mg single oral dose of pregabalin was effective in attenuating maternal anxiety without any sedation effect on mothers in the current study. In contrast to previous studies Singh et al [13] and Doddaiah et al [20], the present study results revealed no effects of single oral dose of 150 mg pregabalin on maternal mean heart rates, mean arterial blood pressures, serum glucose, and cortisol levels during intubation and these finding can be explained first, pregabalin attenuate stress response in a dose-dependent manner in accordance with Meena et al [21] who studied the effects of two different oral doses of pregabalin 150 mg and 300 mg one hour before surgery compared to oral placebo for attenuating cardiovascular response to laryngoscopy and intubation in controlled hypertensive patients and found that 150 mg oral pregabalin and oral placebo were associated with significant rising in the heart rate and mean arterial blood pressure compared to 300 mg after instrumentation of airway. Second, the mechanism by which pregabalin attenuates the stress response of intubation is still unknown and all explanations are just diligence as it may act on inhibiting Ca++ outflow from muscles with squally inhibition of relaxation of smooth muscles [22].…”

Section: Discussioncontrasting

confidence: 59%

The Effects of Pre-emptive Single Dose Oral Pregabalin on Maternal Anxiety and Stress Response to Laryngoscopic intubation During Caesarean Section

Naby

Kamel

Abdelghany

et al. 2021

Egyptian Journal of Anaesthesia

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“…Meena R et al 15 conducted a study on attenuation of cardiovascular response during laryngoscopy and intubation using different doses of oral pregabalin in 150mg and 300mg in controlled hypertensive patients. Oral pregabalin in a dose of 300mg was a better premedicant compared to 150mg as it not only blunted the arterial pressor response to laryngoscopy and intubation, but also provided anxiolysis with reduction of intra-operative anaesthetic drug requirement and maintained haemodynamic stability without significant adverse effects.…”

Section: Discussionmentioning

confidence: 99%

Study to determine the effect of oral pregabalin premedication on haemodynamic response to laryngoscopy, intubation and carbon dioxide insufflation during laparoscopic cholecystectomy

Allu

Kulkarni

Dinesh

2019

Sri Lankan J Anaesthesiol

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Background:The process of laryngoscopy and endotracheal intubation is usually associated with exaggerated haemodynamic response. In extreme cases this response may result in myocardial ischaemia, cardiac failure, increase in intracranial pressure and intracranial haemorrhage. Hence our prospective randomized double blinded placebo control study was designed to observe the effect of pregabalin in attenuating this haemodynamic response. Method:In this study, 100 adult patients of ASAPS I and II undergoing elective laparoscopic cholecystectomy were included. The patients were randomly allocated into two groups, group P received 150mg oral pregabalin and group C received similarly looking B complex capsules one hour before the surgery. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP) were observed. Sedation score was assessed using Ramsay sedation scale. Results:We observed an increase in all the haemodynamic parameters in both the groups. The percentage change in HR and MAP from baseline at one-minute following intubation was +33% and +28.5% in control group compared to +14% and +3% in pregabalin group. Similarly, the percentage change at five minutes after carboperitoneum was +24% and +26% in control group compared to +4% and +0.8% in pregabalin group. This difference was statistically significant with P value <0.05. We also found all the patients in acceptable sedation state (score 3 and 4 based on Ramsay sedation scale) in pregabalin group whereas only 40% patients had a score of 3 in placebo group at 15minutes following extubation. Conclusion:Oral pregabalin in a dose of 150mg one hour before the surgery is a safe and effective premedicant in attenuating pressor response to laryngoscopy, intubation and laparoscopy. It also produces good sedation without any adverse effects.

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Study of Attenuation of Cardiovascular Response during Laryngoscopy and Intubation Using Two Different Doses of Pregabalin as Premedication in Controlled Hypertensive Patients- A RCT

Cited by 7 publications

References 26 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

The Effects of Pre-emptive Single Dose Oral Pregabalin on Maternal Anxiety and Stress Response to Laryngoscopic intubation During Caesarean Section

Study to determine the effect of oral pregabalin premedication on haemodynamic response to laryngoscopy, intubation and carbon dioxide insufflation during laparoscopic cholecystectomy

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