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

Abstract

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.

The Effect of High Dose and Low Dose Pregabalin as Premedication on Preoperative Anxiety and Sedation Levels

“…Adding the sum of 21 statements showed the total anxiety score of the patient, which was between 0-63. Score was further categorized into minimum anxiety (Score of 0-10), mild anxiety (Score of [11][12][13][14][15][16][17][18][19], moderate anxiety (Score of 20-30) and severe anxiety (Score of 31-63) 13 .…”

“…Ondansetron 0.1 mg/kg intravenously (IV). Preoxygenation was done with 100% oxygen (O 2 ) for 3 mins in all patients, after preoxygenation, anesthesia was induce by IV propofol (2 mg/kg), nalbuphine chloride (0.1 mg/kg) followed by atracurium (0.15 mg /kg), a skeletal muscle relaxant, to facilitate endotracheal intubation 14 . The anesthesia was maintained with atracurium, intermittent positive-pressure ventilation (IPPV) N2O:O2-50: 50 and inhalational agent isoflurane at 1.2 Minimum Alveolar Concentration (MAC) and Circle system with CO2 absorber.…”