The effects of preemptive pregabalin on attenuation of stress response to endotracheal intubation and opioid- sparing effect in patients undergoing off-pump coronary artery bypass grafting

Sundar, Ayya Syama; Kodali, Rajeshkumar; Sulaiman, Sajith; Ravullapalli, Harish; Karthekeyan, Ranjith Baskar; Vakamudi, Mahesh

doi:10.4103/0971-9784.91473

Cited by 33 publications

(12 citation statements)

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“…There were 4 studies 19 – 22 with a total of 107 patients taking pregabalin and 110 patients on the control treatment in this group. Pregabalin reduced the pain score at rest 2 hours postsurgery ( P = 0.005).…”

Section: Resultsmentioning

confidence: 99%

“…Thirty studies had included data on the sedative effects of pregabalin, 13 , 14 , 21 , 22 , 25 , 29 , 30 , 32 , 37 , 39 , 43 , 50 – 52 , 55 – 57 , 59 , 60 , 62 , 65 – 69 , 77 , 79 , 82 , 85 , 87 , 88 with a total of 1147 patients taking pregabalin and 1170 patients on the control treatment. Subgroup analysis was performed on studies according to the surgical categories (number of studies) under cardiothoracic surgery (2), ENT surgery (3), gynecologic surgery (4), laparoscopic cholecystectomy (2), orthopedic surgery (7), spine surgery (6), and miscellaneous surgery (6).…”

Section: Resultsmentioning

confidence: 99%

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Efficacy of Pregabalin in Acute Postoperative Pain Under Different Surgical Categories

et al. 2015

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The efficacy of pregabalin in acute postsurgical pain has been demonstrated in numerous studies; however, the analgesic efficacy and adverse effects of using pregabalin in various surgical procedures remain uncertain. We aim to assess the postsurgical analgesic efficacy and adverse events after pregabalin administration under different surgical categories using a systematic review and meta-analysis of randomized controlled trials.A search of the literature was performed between August 2014 to April 2015, using PubMed, Ovid via EMBASE, Google Scholar, and ClinicalTrials.gov with no limitation on publication year or language. Studies considered for inclusion were randomized controlled trials, reporting on relevant outcomes (2-, 24-hour pain scores, or 24 hour morphine-equivalent consumption) with treatment with perioperative pregabalin.Seventy-four studies were included. Pregabalin reduced pain scores at 2 hours in all categories: cardiothoracic (Hedge's g and 95%CI, −0.442 [−0.752 to −0.132], P = 0.005), ENT (Hedge g and 95%CI, −0.684 [−1.051 to −0.316], P < 0.0001), gynecologic (Hedge g, 95%CI, −0.792 [−1.235 to −0.350], P < 0.0001), laparoscopic cholecystectomy (Hedge g, 95%CI, –0.600 [–0.989 to –0.210], P = 0.003), orthopedic (Hedge g, 95%CI, −0.507 [−0.812 to −0.202], P = 0.001), spine (Hedge g, 95%CI, −0.972 [−1.537 to −0.407], P = 0.001), and miscellaneous procedures (Hedge g, 95%CI, −1.976 [−2.654 to −1.297], P < 0.0001). Pregabalin reduced 24-hour morphine consumption in gynecologic (Hedge g, 95%CI, −1.085 [−1.582 to −0.441], P = 0.001), laparoscopic cholecystectomy (Hedge g, 95%CI, –0.886 [–1.652 to –0.120], P = 0.023), orthopedic (Hedge g, 95%CI, −0.720 [−1.118 to −0.323], P < 0.0001), spine (Hedge g, 95%CI, −1.016 [−1.732 to −0.300], P = 0.005), and miscellaneous procedures (Hedge g, 95%CI, −1.329 [−2.286 to −0.372], P = 0.006). Pregabalin resulted in significant sedation in all surgical categories except ENT, laparoscopic cholecystectomy, and gynecologic procedures. Postoperative nausea and vomiting was only significant after pregabalin in miscellaneous procedures.Analgesic effects and incidence of adverse effects of using pregabalin are not equal in different surgical categories.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Efficacy of Pregabalin in Acute Postoperative Pain Under Different Surgical Categories

et al. 2015

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“…This is consistent with other studies, where it was demonstrated that pregabalin offered better sedation and anxiolysis when compared to placebo and clonidine. [ 3 13 ]…”

Section: Discussionmentioning

confidence: 99%

“…[ 2 ] Adequate premedication has been shown to attenuate this pressor response. Sundar et al .,[ 3 ] showed that the mean systolic and diastolic pressure during different time periods after intubation were significantly lower with 150 mg of pregabalin premedication compared with placebo. Gupta et al .…”

Section: Introductionmentioning

confidence: 99%

Premedication dilemmas, is Pregabalin the answer?

et al. 2015

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Objective:Laryngoscopy and intubation are associated with sympathetic stimulation which can prove deleterious in patients with cardiovascular compromise; so, various methods have been tried to obtund this pressor response. In this study, we have assessed the efficacy of pregabalin in attenuating the pressor response to laryngoscopy and intubation.Methods:This prospective randomized study included 80 patients with American Society of Anesthesiologists physical status grades I-II, in the age group of 18–60 years of age. The patients were randomized into two groups of 40 patients each. Group A received the placebo orally, 90 min prior to surgery. Group B received 150 mg of pregabalin orally, 90 min prior to surgery. These patients were assessed in terms of sedation with Ramsay sedation scale (RSS). In the operation theatre, the heart rate (HR), systolic blood pressure, diastolic blood pressure, mean arterial pressure, and oxygen saturation recorded at baseline and 1, 3, 5, and 10 min after intubation. The rate pressure product (RPP) was calculated for these time intervals. In the postoperative period, patients were assessed for complications like dizziness, nausea, and blurred vision. Statistical analysis was performed using Chi-square and ANOVA tests.Findings:The group receiving 150 mg of pregabalin as premedication was found to be adequately sedated at 1 h post-premedication with 52% patients having a RSS score of 3 compared to 4% with the same RSS score in the placebo group (P < 0.0001). Hemodynamics was more stable post-intubation with significant stability in the HR (P = 0.002) and RPP (P = 0.004) in the pregabalin group.Conclusion:Pregabalin when given as a premedication provides adequate sedation and obtunds the pressor response seen with intubation.

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“…In other studies, the results were unstable as time to extubation was significantly longer in the pregabalin group [2, 3] or similar between groups [4, 5]. …”

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confidence: 93%