To Study And Compare The Analgesic Effect Of Oral Pregablin 150mg Verses Oral Pregablin 75mg On The Occurrence Of Acute Post Thoracotomy Pain.

Abstract

Background: Thoracotomy is widely recognized as being one of the most painful surgical procedure. Pain relief, is therefore essential to facilitate coughing and deep breathing and to promote early mobilization. Nowadays pain control is one of the most important challenges for anesthesiologist. The purposes of this observational study was to compare the effect of pregabalin with epidural analgesia on acute post thoracotomy pain.

Objectives: To study the effectiveness of pregabalin on acute post thoracotomy pain, any adverse effect of preoperative pregabalin and Analgesic (Opioid) -sparing effect of pregabalin among the studied groups.

Study Design: Prospective Double Blind Observational Study

Participants: Adult patients with ASA I, II and III age group of 20-60 years both genders undergoing one sided thoracotomy. .

Methods: This study was conducted on 99 patients who underwent thoracotomy. Patients selected for the study were randomised into three groups, Group A (Pregabalin 150mg) , Group B (Pregabalin 75mg) and Group C (Control) using a set of cards drawn in the operating room by a person not involved in the study at any stage. The patients were kept fasting as per hospital protocol. . All three groups received the same anesthetic technique. All patients were clinically evaluated, assessed and investigated before surgery. All three groups received Thoracic epidural analgesia with 4-5ml of 0.2% Ropivacaine as a standard for acute post thoracotomy pain relief. After the procedure and extubation, patients were assessed for pain by using scoring system at zero, four, six, 12, 24, 36, 48 hrs.

Results: There was statistically significant difference in pain score (VAS) of three groups on comparing Group A verses Group B verses Group C (P<0.05) . There was statistically significant difference in epidural top-up requirements on comparing Group A verses Group B verses Group C. (P <0.05) . The incidence of complication i. e. dizziness, nausea, vomiting and dry mouth were reported in all the three study groups were statistically not significant (p< 0.05) . Cardiovascular and respiratory complication did not reported in any patients in our study.

Conclusion: The oral pregabalin 150 mg and pregabalin 75 mg once a day given oral two hours prior to surgery and continued for two postoperative days for every 24 hours, was sufficient to reduce pain score postoperatively when compared to Pregabalin 150 mg verses Pregabalin 75 mg verses Control.

Implication: pregabalin could improve acute pain control and reduce opioid consumption. pregabalin is a safe and effective analgesic drug which decrease need of epidural rescue top ups.