Indian Journal of Clinical Anaesthesia

Post-operative pain is one of the main areas on which research is being under taken nowadays. This has led to the emergence of concept of preemptive analgesia to prevent post-operative pain by inhibiting the nociceptive stimuli. This study aims at assessing whether pregabalin as pre-medicant has any superadded benefit on prolonging the analgesic effect of spinal anaesthesia and post-operative analgesic requirements in patients posted for hysterectomy.

A total of 60 patients of ASA grade I and II posted for elective hysterectomies were randomly allocated in two groups of 30 each. The blinded drug selected for the study was given orally one hour before surgery. Group A received pre-medication with placebo capsule and Group B received pregabalin caspsule 75mg. Spinal anaesthesia was performed using 26 G spinal needle at L2–3/L3–4 interspace with 3ml of 0.5% bupivacaine heavy injected. VAS score at first rescue analgesia, mean time of onset of sensory and motor block, duration of analgesia and total requirement of rescue analgesia were observed as primary outcome. Haemodynamic parameters and side effects were recorded as secondary outcome.

The mean duration of effective analgesia was comparable in group A (141±6.7 mins) and group B (149.33±10.807 mins). The mean VAS scores in pregabalin group were significantly reduced compared to the placebo group (p<0.05). The mean number of doses of rescue analgesia in the first 24 hours in group A and B was 3.16±0.08 and 2.23 ±0.05 respectively (p<0.001). There were no significant hemodynamic changes in group A and B. Incidence of perioperative adverse effects were similar in both the groups.

Oral pregabalin 75mg as premedicant has comparable duration of spinal analgesia. However the VAS scores and number of doses of rescue analgesics used were significantly less in the pregabalin group compared to the placebo group.