The Effect Of The Use Of Pre-Emptive Oral Pregabalin On The Postoperative Spinal Analgesia In Patients Presented For Orthopedic Surgeries: Randomized Controlled Trial

Background: Preoperative oral pregabalin could improve postoperative analgesia and prevent chronic pain development. The aim of this study is to evaluate the effect of oral pregabalin on the duration and quality of postoperative analgesia in spinal anesthesia. Methods: Sixty adult patients presented for internal fixation of femoral fracture under spinal anesthesia were included in the study. They were randomly distributed to a placebo group and a pregabalin group receiving 150 mg pregabalin capsules 1 hr before surgery. The onset, duration, and regression of sensory and motor block were recorded. Rescue analgesia consumption, postoperative pain score, and quality of sleep were also assessed. Results: Oral pregabalin significantly prolonged the time to two-segment regression of sensory block, reaching 86.67 +/- 17.88 mins, the time required to regression of spinal block to L2, reaching 155.33 +/- 34.71 mins, and the duration of motor block, reaching 138 +/- 23.5 mins, with no effect on the onset of sensory or motor block (P = 0.60 and 0.62). It significantly decreased the VAS score 4 hrs, 6 hrs, and 12 hrs postoperatively, prolonged the duration of postoperative analgesia, reaching 392.00 +/- 47.23 mins, and decreased morphine consumption to 7.67 +/- 3.65 mg. It also improved the quality of sleep in the first night after surgery. Conclusion: Preemptive oral pregabalin prolonged the time to the first request for postoperative analgesics and improved sleep in the first night after surgery.