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Published in: European Archives of Oto-Rhino-Laryngology 8/2019

01-08-2019 | Septorhinoplasty | Rhinology

Low-dose preoperative pregabalin improves postoperative pain management in septorhinoplasty surgery: a double-blind randomized clinical trial

Authors: Pejman Pourfakhr, Mohammad Reza Khajavi, Ali Jalali, Faramarz Memari, Farhad Etezadi, Mehrnoush Momeni Roochi, Reza Shariat Moharari, Atabak Najafi

Published in: European Archives of Oto-Rhino-Laryngology | Issue 8/2019

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Abstract

Purpose

To evaluate the efficacy of single low dose (75 mg) preoperative pregabalin in reducing post-operative pain of septorhinoplasty.

Methods

A double blind single center Randomized controlled trial based on block randomization. In the pregabalin group (PG) 34 participants received 75 mg pregabalin orally one hour before anesthesia induction while in control group (CG) 34 participants received a placebo. Pain and sedation were repeatedly measured with Visual Analouge Scale (VAS) and Riker Sedation-Agitation Scale (RSAS) respectively, 0.5, 1, 2, 6, 24 hours postextubation. Cumulative doses of fentanyl and ibuprofen received in both groups were compared.

Results

Thirty-two of the participants in PG and 33 of the participants in CG completed the study. The Mean VAS pain score was less in PG versus CG 30 min postoperatively (2.30 ± 1.30 vs. 4.85 ± 1.17), one hour (2.28 ± 0.92 vs. 4.27 ± 0.78), two hours (2.11 ± 0.88 vs. 3.60 ± 0.61) and six hours (1.47 0.62 vs. 2.76 ± 0.91) but not 24-hours postoperatively (0.84 ± 0.62 vs. 1.09 ± 0.92). Participants in the PG were less agitated during early post-extubation period (at 10 min: RSAS 3.93 ± 0.43 vs. 4.42 ± 0.50) and more alert during the first hour post-extubation (at 60 min: RSAS 3.90 ± 0.29 vs. 3.36 ± 0.69). The total dose of rescue fentanyl and ibuprofen was lower in the PG compared to the CG.

Conclusions

A single dose of 75 mg pregabalin is very effective for pain control after septorhinoplasty procedure when administered one hour before anesthesia induction. Side effects are rare and opioid sparing was noted.

Trial registration

Clinical trial number: IRCT2017043033706N1
Literature
1.
go back to reference de Leon-Casasola OA (1996) New concepts in postoperative pain management: is there more beyond pain control? J Fla Med Assoc 83(10):695–700PubMed de Leon-Casasola OA (1996) New concepts in postoperative pain management: is there more beyond pain control? J Fla Med Assoc 83(10):695–700PubMed
2.
go back to reference Vanderah TW, Suenaga NM, Ossipov MH, Malan TPJ, Lai J, Porreca F (2001) Tonic descending facilitation from the rostral ventromedial medulla mediates opioid-induced abnormal pain and antinociceptive tolerance. J Neurosci 21(1):279–286CrossRefPubMed Vanderah TW, Suenaga NM, Ossipov MH, Malan TPJ, Lai J, Porreca F (2001) Tonic descending facilitation from the rostral ventromedial medulla mediates opioid-induced abnormal pain and antinociceptive tolerance. J Neurosci 21(1):279–286CrossRefPubMed
6.
go back to reference Kehlet H, Dahl JB (1993) The value of “multimodal” or “balanced analgesia” in postoperative pain treatment. Anesth Analg 77(5):1048–1056CrossRefPubMed Kehlet H, Dahl JB (1993) The value of “multimodal” or “balanced analgesia” in postoperative pain treatment. Anesth Analg 77(5):1048–1056CrossRefPubMed
18.
go back to reference Lauria-Horner BA, Pohl RB (2003) Pregabalin: a new anxiolytic. Expert Opin Investig Drugs 12(4):663–672CrossRefPubMed Lauria-Horner BA, Pohl RB (2003) Pregabalin: a new anxiolytic. Expert Opin Investig Drugs 12(4):663–672CrossRefPubMed
19.
go back to reference Generoso MB, Trevizol AP, Kasper S, Cho HJ (2017) Pregabalin for generalized anxiety disorder: an updated systematic review and meta-analysis. Int Clin Psychopharmacol 32(1):49–55CrossRefPubMed Generoso MB, Trevizol AP, Kasper S, Cho HJ (2017) Pregabalin for generalized anxiety disorder: an updated systematic review and meta-analysis. Int Clin Psychopharmacol 32(1):49–55CrossRefPubMed
Metadata
Title
Low-dose preoperative pregabalin improves postoperative pain management in septorhinoplasty surgery: a double-blind randomized clinical trial
Authors
Pejman Pourfakhr
Mohammad Reza Khajavi
Ali Jalali
Faramarz Memari
Farhad Etezadi
Mehrnoush Momeni Roochi
Reza Shariat Moharari
Atabak Najafi
Publication date
01-08-2019
Publisher
Springer Berlin Heidelberg
Published in
European Archives of Oto-Rhino-Laryngology / Issue 8/2019
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-019-05448-y

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