Comparing the Efficacy of Oral Pregabalin Premedication with Placebo on Stress Response in Patients Undergoing Laparoscopic Cholecystectomy After Creation of Pneumoperitoneum

Iqra  Aziz; Muhammad  Aatir Fayaz; Muhammad  Usman Mohsin; Muhammad  Kaleem Sattar; Atqua  Sultan; Muhammad  Adnan

doi:10.54112/bcsrj.v6i1.1503

Authors

Iqra Aziz Department of Anesthesia, Nishtar Medical University and Hospital Multan, Pakistan
Muhammad Aatir Fayaz Department of Anesthesia, Nishtar Medical University and Hospital Multan, Pakistan
Muhammad Usman Mohsin Department of Anesthesia, Nishtar Medical University and Hospital Multan, Pakistan
Muhammad Kaleem Sattar Department of Anesthesia, Tertiary Care Hospital Nishtar II Multan, Pakistan
Atqua Sultan Department of Anesthesia, Nishtar Medical University and Hospital Multan, Pakistan
Muhammad Adnan Department of Anesthesia, Nishtar Medical University and Hospital Multan, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v6i1.1503

Keywords:

Pregabalin, Hemodynamics, Pneumoperitoneum

Abstract

Hemodynamic fluctuations following pneumoperitoneum creation during laparoscopic cholecystectomy pose a challenge in anaesthesia management. Pregabalin, a gabapentinoid, has shown potential in attenuating this stress response. Objective: To compare the effects of oral pregabalin premedication with placebo on heart rate (HR) and mean arterial pressure (MAP) in patients undergoing laparoscopic cholecystectomy. Methodology: This prospective study was conducted at the Department of Anesthesiology, Nishtar Medical University and Hospital, Multan, from June 23, 2023, to December 22, 2023. Sixty patients were randomly assigned to two groups: Group A received 150 mg of oral pregabalin one hour before general anaesthesia, while Group B received a placebo. Standard intraoperative monitoring was used, and HR, systolic blood pressure (SBP), diastolic blood pressure (DBP), and MAP were recorded. Data were analysed using SPSS version 27, and an independent sample t-test was used to compare hemodynamic parameters between the two groups, with a significance level of p<0.05. Results: After five minutes of pneumoperitoneum creation, Group A had significantly lower HR (78.23 ± 5.03 bpm vs. 87.50 ± 5.73 bpm, p<0.001), MAP (91.73 ± 5.06 mmHg vs. 100.79 ± 5.33 mmHg, p<0.001), SBP (121.20 ± 8.34 mmHg vs. 131.57 ± 8.59 mmHg, p<0.001), and DBP (77.00 ± 5.64 mmHg vs. 85.40 ± 5.33 mmHg, p<0.001) compared to Group B. Conclusion: Oral pregabalin premedication effectively attenuates the hemodynamic stress response following pneumoperitoneum creation in laparoscopic cholecystectomy. Its use as a premedication can enhance perioperative hemodynamic stability.

Downloads

Download data is not yet available.

References

Umano GR, Delehaye G, Noviello C, Papparella A. The “dark side” of pneumoperitoneum and laparoscopy. Minimally Invasive Surgery. 2021;2021(1):5564745.

Jain R, Kumar M, Singh T, Rautela R, Kumar S. Effect of oral gabapentin premedication on hemodynamic parameters and postoperative pain in patients of laparoscopic cholecystectomy: A randomized double-blind controlled study. Journal of Anaesthesiology Clinical Pharmacology. 2021;37(1):67-72.

Goel A, Gupta S, Bhagat TS, Garg P. Comparative analysis of hemodynamic changes and shoulder tip pain under standard pressure versus low-pressure pneumoperitoneum in laparoscopic cholecystectomy. Euroasian journal of hepato-gastroenterology. 2019;9(1):5.

Tan W, Qian D-c, Zheng M-m, Lu X, Han Y, Qi D-y. Effects of different doses of magnesium sulfate on pneumoperitoneum-related hemodynamic changes in patients undergoing gastrointestinal laparoscopy: a randomized, double-blind, controlled trial. BMC anesthesiology. 2019;19:1-11.

Parveen S, Negi DS, Kumar R, Bagwan MC. Oral clonidine vs oral pregabalin premedication to attenuate pressor response to direct laryngoscopy in patients undergoing laparoscopic cholecystectomy: a randomized double blind study. Journal of clinical and diagnostic research: JCDR. 2016;10(9):UC21.

Ghomeishi A, Mohtadi AR, Behaeen K, Nesioonpour S, Golbad ES, Bakhtiari N. Comparison of the effect of propofol and isoflurane on hemodynamic parameters and stress response hormones during Laparoscopic Cholecystectomy surgery. Journal of Anaesthesiology Clinical Pharmacology. 2022;38(1):137-42.

Agrawal S, Bhagat S, Deshmukh P, Singham A. Pregabalin as a premedicant to attenuate pressor response in patients undergoing laparoscopic cholecystectomy: A prospective, randomized, double-blind, placebo-controlled study. Int J Res Pharm Sci. 2020;11(3):3418-23.

Sachdev S, Malawat A, Jethava D, Gupta S, Moin K. Role of Oral Pregabalin as Premedication in Attenuation of Hemodynamic Responses to Laryngoscopy, Intubation, and Extubation in Patients Undergoing Laparoscopic Cholecystectomy: A Randomized Clinical Trial. system. 2019;14:15.

Allu H, Kulkarni M, Dinesh E. Study to determine the effect of oral Pregabalin premedication on haemodynamic response to laryngoscopy, intubation and carbon dioxide insufflation during laparoscopic cholecystectomy. Sri Lankan Journal of Anaesthesiology. 2019;27(1).

Das M, Ray M, Mukherjee G. Haemodynamic changes during laparoscopic cholecystectomy: effect of clonidine premedication. Indian Journal of Anaesthesia. 2007;51(3):205-10.

Saxena SN. Evaluating the effect of low dose dexmedetomidine infusion on hemodynamic response in patients undergoing laparoscopic cholecystectomy.

Prakash R, Kushwaha B, Kumar S. A comparative study of fentanyl and clonidine on hemodynamic response to pneumoperitoneum in laparoscopic cholecystectomy. Int J Sci Eng Res. 2014;5:1552-8.

Bajwa SJS, Kaur J, Singh A, Parmar S, Singh G, Kulshrestha A, et al. Attenuation of pressor response and dose sparing of opioids and anaesthetics with pre-operative dexmedetomidine. Indian journal of anaesthesia. 2012;56(2):123-8.

Jain M, Ramani M, Gandhi S, Jain C, Sarvanan V. A Randomized Controlled Study to Compare Hemodynamic Effects between Clonidine and Pregabalin in Laparoscopic Cholecystectomy. Anesthesia Essays and Researches. 2020;14(1):4-15.

Suryawanshi C, Pati Sathvika DDGR, Jawale R. A COMPARATIVE EVALUATION OF ORAL CLONIDINE VERSUS ORAL PREGABALIN PREMEDICATION FOR ATTENUATION OF PRESSOR RESPONSE DURING LARYNGOSCOPY, INTUBATION AND PNEUMOPERITONEUM IN PATIENTS IN LAPAROSCOPIC SURGERY. Journal of Pharmaceutical Negative Results. 2022:6527-36.

Pal RK, Sah SK, Chattopadhyay S, Barik S. A comparative study of oral clonidine and oral pregabalin as premedication for the control of haemodynamic surge in patients undergoing elective laparoscopic cholecystectomy. Asian Journal of Medical Sciences. 2023;14(10):21-8.

Patodi V, Yadav RL, Sethi SK, Jain N, Singh M. A comparative study between two different doses of oral pregabalin in attenuating hemodynamic response to laryngoscopy and endotracheal intubation. Anaesthesia, Pain & Intensive Care. 2020;24(1):28-35.

Rathore P, Saini V, Ahmed F, Chatterjee R, Rathore M. A comparative study of oral clonidine versus oral pregabalin on hemodynamic responses to laryngoscopy and endotracheal intubation under general anesthesia. Int J Med Biomed Stud. 2019;3(4):217-22.