Turkiye Klinikleri Journal of Medical Sciences

.: ORIGINAL RESEARCH
Evaluation of Preoperative Anxiolytic and Postoperative Analgesic Effects of Pregabalin Premedication
Pregabalin Premedikasyonunun Preoperatif Anksiyolitik ve Postoperatif Analjezik Etkilerinin Değerlendirilmesi
Selma BORA POLATa, İclal ÖZDEMİR KOLa, Onur AVCIa, Ahmet Cemil İŞBİRa, Kenan KAYGUSUZa, Sinan GÜRSOYa
aDepartment of Anesthesiology and Reanimation, Sivas Cumhuriyet University Faculty of Medicine, Sivas, TURKEY
Turkiye Klinikleri J Med Sci. 2019;39(1):9-18
doi: 10.5336/medsci.2018-62181
Article Language: EN
Full Text
ABSTRACT
 Objective: The studies about use of pregabalin for premedication have been recently carried out due to pregabalin has analgesic and anxiolytic effects together. We aimed to evaluate the effects of preoperative pregabalin on anxiety score, hemodynamic parameters, postoperative pain and analgesic consumption in patients undergoing elective abdominal hysterectomy. Material and Methods: The patients were randomly separated into 34 patients of two groups. This prospective randomized, double-blind and placebo-controlled study was performed in patients undergoing elective abdominal hysterectomy. Pregabalin 150 mg (Pregabalin Group) or placebo 150 mg empty capsule (Control Group) was given to the patients 12 hours and 1 hour before operation. STAI-I (State-Trait Anxiety Inventory-I) anxiety scale were performed to the patients during preoperative examination and 1 hour before operation. In both groups, intraoperative hemodynamic parameters, postoperative pain levels with VAS (Visual Analogue Scale), morphine consumption and developing side effects were recorded and analyzed. Results:When all patients were compared from the point of demographic data, no difference was found between groups. STAI-I points were found significantly different between Pregabalin and Control groups both premedication and postmedication phases. MAP (Mean Arterial Pressure) data were found lower in pregabalin group at intraoperative 30th, 40th and 75th minutes and postoperative 1st minute (p<0.05). Postoperative VAS values were found lower in Pregabalin Group. Additional analgesic use and morphine consumption, were lower in Pregabalin group except 1st and 30th minutes. When both groups, examined with regard to side effects, side effect rates of Control Group were 29% and rates of Pregabalin Group were 10%. Conclusion: In this study, it was concluded that pregabalin use at 12 and 1 hour before operation decreased preoperative anxiety score, provided postoperative analgesia and found superior to placebo due to decreasing side effects via decreasing the consumption of analgesics, however for the routine use of pregabalin in premedication it was needed further studies with different doses and large sample sizes.

Keywords: Premedication; postoperative pain; pregabalin; preoperative anxiety
ÖZET
 Amaç: Pregabalinin analjezik ve anksiyolitik etkinliği birarada taşıması nedeniyle son dönemde premedikasyonda kullanımı ile ilgili çalışmalar yapılmaktadır. Elektif abdominal histerektomi geçirecek hastalarda preoperatif pregabalin kullanımının anksiyete skoru, hemodinamik parametreler, postoperatif ağrı ve analjezik tüketimi üzerine etkilerini değerlendirmeyi amaçladık. Gereç ve Yöntemler: Hastalar rastgele 34 kişilik 2 gruba ayrıldı. Bu prospektif randomize, çift kör ve plasebo kontrollü çalışma elektif abdominal histerektomi geçirecek hastalarda gerçekleştirildi. Hastalara operasyondan 12 saat ve 1 saat önce pregabalin 150 mg (Pregabalin grubu) veya plasebo 150 mg boş kapsül (Kontrol grubu) verildi. Hastalara preoperatif muayene sırasında ve operasyondan 1 saat önce State-Trait Anxiety Inventory-I (STAI-I) anksiyete ölçeği uygulandı. Her iki grupta, peroperatif hemodinamik parametreler, VAS ile postoperatif ağrı düzeyleri, morfin tüketimleri ve gelişen yan etkiler kaydedilerek analiz edildi. Bulgular: Tüm hastalar demografik veriler yönünden karşılaştırıldığında gruplararası anlamlı bir fark görülmedi. Pregabalin ve Kontrol grubunda, premedikasyonda ilaç verilmeden önceki ve sonraki STAI-I puanları yönünden gruplararası farklılık anlamlı bulundu. İntraoperatif 30., 45., 75. ve postoperatif 1. dakikadaki OAB (Ortalama Arteryal Basınç) Pregabalin grubunda daha düşük seyretti. Postoperatif VAS (Vizüel Analog Skala) değerleri Pregabalin grubunda daha düşük bulundu. Ek analjezik kullanımı ve morfin tüketimleri 30 dakikadan sonra Pregabalin grubunda daha düşüktü. Her iki grup, yan etki yönünden incelendiğinde Kontrol grubunda %29 yan etki izlenirken, Pregabalin grubunda %10 olarak izlendi. Sonuç: Genel anestezi altında abdominal histerektomi geçirecek hastalarda, operasyondan 12 saat ve 1 saat önce uygulanan 150 mg pregabalinin preoperatif anksiyete skorlarını azalttığı, postoperatif analjezi sağladığı ve analjezik tüketimini azaltarak buna bağlı yan etkileri de azaltması nedeniyle plaseboya üstün olduğu, ancak pregabalinin rutin premedikasyona kazandırılabilmesi için farklı dozlar ve geniş örneklem grupları ile çalışmaların yapılması gerektiği sonucuna varıldı.

Anahtar Kelimeler: Premedikasyon; postoperatif ağrı; pregabalin; preoperatif anksiyete
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