Volume 23 No 1 (2025)
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The Study to Evaluate Intraoperative Sedative and Perioperative Analgesic Requirement of Pregabalin (75) MG in Tympanoplasty- A Randomized Controlled Study
Dr. Maya Vilas Kamalakar, Dr. Ganesh Manohar Vihapure, Dr. Pavan Dhulkhed, Dr. Vithal Dhulkhed
Abstract
Background Tympanoplastyis a surgical technique to repair a defect in the tympanic membrane with the placement of a graft. Use of opioids to control sympathetic response may lead to hypotension,postoperative respiratory depression and delayed recovery. Gabapentinoidshave anti-nociceptive effects. They reduce opioid requirement in multimodal analgesia techniques.Pregabalin is a gabapentinoid drug.It has been used in doses of50 mg,75 mg,150mg,300mg and 600mgas premedication by oral route. The effects of pregabalin have not been studied for monitored anaesthesia care in tympanoplasty. The aim of our study was to assess the efficacy ofpregabalin (75 mg) administered as oral premedication to reduce intraoperative sedative andanalgesic requirementandside effects in patients undergoing tympanoplasty under monitored anaesthesia care. Methods Sixty patientswere randomly selected to receive either pregabalin (in Group A) 75 mg tablet or similar looking controlled drug i.e., B complex (inGroup B),as oralpremedicationone hour before surgery.Injection midazolam intravenous bolus was given followed by infusion. Patient having Numerical Rating Scale(NRS)≥4 or complaint of pain,injection fentanyl was used as rescue analgesic. Postoperatively time to request first analgesic was noted. Inclusion Criteria American Society of Anesthesiologists (ASA) physical status I–II patients of 18-60 years of age. Exclusion Criteria Allergic to study drug, Pregnancy, Patient refusal. Results The total midazolam consumption inB complex Groupwas 3.25 ± 0.33 mgand3.04 ± 0.38 mginpregabalinGroup, p=0.03.The total fentanyl consumption inB complex groupwas 76.67± 15.82 mcgandin pregabalingroup itwas 35.33 ± 8.6 mcgp=0.000, Time to first request of analgesic was354 ± 63 mins in B complex groupand444 ± 64mins inpregabalingroup. Conclusion Premedication with pregabalin75mgsignificantly reduced the requirement of fentanyl and midazolamduring monitored anaesthesia carefor tympanoplasty.It significantly prolonged postoperativeanalgesia durationand reduced postoperative analgesic requirement.
Keywords
Midazolam, Monitored Anaesthesia Care,NRS Score.
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