Preoperative administration of pregabalin would reduce the end tidal concentration of sevoflurane during laparoscopic cholecystectomy with added beneficial improving of the quality of postoperative analgesia.
laparoscopic cholecystectomy is a painful and stressful surgical procedure. Pregabalin is a lipophilic structural analogue of the inhibitory γ-aminobutyric acid by binding to the presynaptic voltage-gated calcium channels that are widely distributed throughout the central and peripheral nervous system. Pregabalin has anticonvulsant, anxiolytic, sleep-modulating, anti-hyperalgesic, opioid-sparing6 and anti-allodynic properties through inhibition of the release of excitatory neurotransmitters such as glutamate, norepinephrine, serotonin, dopamine and substance P. These unique characteristics make pregabalin as a useful therapeutic for treating neuropathic pain and acute postoperative pain in several models of incisional injury and inflammatory conditions including laparoscopic cholecystectomy.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
42
to receive two identical placebo capsules 1 hr before surgery
one capsule of pregabalin 150 mg and one placebo capsule 1 hr before surgery
two capsules of pregabalin 150 mg 1 hr before surgery
Mansoura University Hospitals
Al Mansurah, DK, Egypt
changes in the end tidal sevoflurane concentrations
End-tidal concentrations of sevoflurane (Et-Sevo) were recorded every 15 min after intubation until the skin closure.
Time frame: intraoperative every 15 min
hemodynamic parameters
heart rate and mean arterial blood pressure were recorded before (baseline), 45 min after the administration of the study capsules; every 15 min after intubation until the skin closure and every 15 min for the first hour after extubation.
Time frame: before surgery, after the administration of the study capsules; intraoperative, an expected average of 2 hours, up to 24 after surgery
intraoperative fentanyl supplementations
intraoperative fentanyl supplementations
Time frame: intraoperative, an expected average of 2 hours
quality of tracheal extubation
The quality of tracheal extubation was evaluated using a 5 - points rating scale: 1, no coughing or straining; 2, very smooth, minimal coughing; 3, moderate coughing; 4, marked coughing or straining; and 5, poor extubation, very uncomfortable
Time frame: up to 24 after surgery
postoperative cumulative morphine consumption
postoperative cumulative morphine consumption
Time frame: up to 24 after surgery
postoperative sedation and pain scores
Postoperative pain VAS scores sedation (four-point verbal rating scores (VRS): awake, drowsy, rousable or deep sleep)
Time frame: up to 24 after surgery
postoperative nausea and vomiting
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nausea and vomiting (0: no nausea; 1: nausea no vomiting; 2: nausea and vomiting)
Time frame: up to 24 after surgery
awareness and recall
The patients were asked about intraoperative awareness and recall on the second postoperative day by asking three simple questions using standard interview "What was the last thing you remembered happening before you went to sleep? What is the first thing you remember happening on waking? Did you dream or have any other experiences whilst you were asleep?"
Time frame: intraoperative, an expected average of 2 hours