Original Research Article
Year: 2020 | Month: May | Volume: 10 | Issue: 5 | Pages: 181-191
Effect of Oral Gabapentin vs. Pregabalin as Preemptive Analgesic for Postoperative Pain in Patients Undergoing Lumbar Spine Surgeries
Atul Sharma1, Rashmi Datta2, V.B. Sharma3
1P.G. Student, 2Senior Consultant & Professor, 3Senior Advisor (Anaesthesiology & NeuroAnaes) & Assistant Professor
Deptt. of Anaesthesiology and Critical Care, Command Hospital (WC), Chandimandir, Panchkula, Haryana- 134107
Corresponding Author: Atul Sharma
ABSTRACT
Background: Gabapentin is a novel drug used for the treatment of postoperative pain with antihyperalgesic properties and a unique mechanism of action, which differentiates it from other commonly used drugs. Recently, role of Gabapentinoids (Pregabalin and Gabapentin) in acute postoperative pain has been studied indicating its usefulness in preventing the acute nociceptive pain of surgery.
Aims and Objectives: To compare the efficacy of Gabapentin and Pregabalin with intravenous Paracetamol as preemptive analgesic.
Material and Methods: This prospective, randomized, double blind comparative study included one hundred and twenty patients who belonged to American Society of Anesthesiologists physical status class I to II, aged between 20-65 years who underwent lumbar spine surgery under general anaesthesia.
Results: Mean age of patients was 39.88±10.68 for placebo group followed by Gabapentin group 38.55±12.44 and Pregabalin group 37.30±11.26. Time to first analgesic showed lowest time for placebo group with as early as 76 minutes followed by Gabapentin group with 93 minutes. Pregabalin group subjects had the first analgesic request at the highest time with 136.5 minutes. The VAS score was significantly lower in the Pregabalin group at 0, 2, 3, 6, 9, 12 and 24 hrs after surgery. The VAS score was significantly lower in the Gabapentin group as compared to placebo at 0, 1, 3, 6, 12, 18 and 24 hrs after procedure. Headache was the most common among Gabapentin group, followed equally by placebo and Pregabalin groups. Nausea was equally reported by Gabapentin and placebo group. Dizziness was seen equally among placebo and Pregabalin group followed by Gabapentin group. Total rescue analgesic (Tramadol) dosage in the first 24 hrs after the surgery shows that Placebo group patients required more rescue analgesic i.e. 113.64±69.90 as compared to Pregabalin i.e. 110.50±57.67 and Gabapentin groups 110.00±53.17.
Conclusion: The study concluded that Pregabalin along with IV Paracetamol has a better analgesic profile and delays the time for requirement of first dose of rescue analgesic compared to Gabapentin along with IV Paracetamol following lumbar spinal surgery.
Key words: Gabapentin, Preemptive Analgesic, Postoperative pain, Lumbar spine