The Efficacy Of Preemptive Pregabalİn Administration on Pre-and Postoperative Anxiety and Postoperative Analgesia in Arthroscopic Shoulder Surgery: A Prospective, Randomized, Double-Blind, Placebo-Controlled Clinical Study

Year 2022, Volume: 32 Issue: 1, 12 - 18, 28.02.2022

Faruk Çiçekci , Mehmet Sargın , Ahmet Yıldırım , Muslu Kazım Körez , Göksun Günaydın İnci Kara

https://doi.org/10.54005/geneltip.999386

Cited By: 1

Abstract

Aim: Few studies have investigated pregabalin use as preemptive analgesia in the management of acute pain and anxiety following arthroscopic shoulder surgery. We hypothesized that the preemptive use of oral pregabalin might decrease pain and postoperative anxiety on arthroscopic shoulder surgery pain during the initial 48 hours.
Patients and methods: In this prospective, randomized, double-blind, placebo-controlled study, 65 eligible patients were randomly divided into two groups, the preemptive pregabalin 150 mg (group P) and the control group (group C). The primary outcomes were pain levels measured both rest and during active motion based on a visual analog scale (VAS). Secondary outcomes were the level of anxiety (STAI-S and STAI-T), patient satisfaction, and complications.
Results: Group P showed lower pain (p < 0.001), better opioid consumption (p < 0.001), longer time to first requirement of analgesia (p < 0.001), and lower rescue analgesic dose (p < 0.001) than the control group at postoperative 48 h follow-up. Also, group P showed less preoperative and postoperative anxiety (p < 0.001) and greater patient satisfaction (p < 0.001) than group C. The rate of postoperative adverse effects was similar between the groups (p > 0.05).
Conclusion: The preemptive use of oral pregabalin received 150 mg daily for 2 days before surgery provided postoperative analgesia in both rest and active motion, and improved preoperative and postoperative anxiety levels and greater patient satisfaction in patients undergoing arthroscopic surgery.

Keywords

Analgesia, anxiety, preemptive, pregabalin, orthopedic surgery

ARTROSKOPİK OMUZ CERRAHİSİNDE PREEMPTİF PREGABALİN YÖNETİMİNİN POSTOPERATİF VE POSTOPERATİF ANKSİYETE VE POSTOPERATİF ANALJEZİ ÜZERİNE ETKİNLİĞİ: PROSPEKTİF, RANDOMİZE, ÇİFT KÖR, PLASEBO KONTROLLÜ BİR KLİNİK ÇALIŞMA

Abstract

Amaç: Artroskopik omuz cerrahisini takiben akut ağrı ve anksiyete tedavisinde pregabalinin preemptif analjezi olarak kullanımını araştıran az sayıda çalışma bulunmaktadır. Oral pregabalinin preemptif kullanımının, ilk 48 saat boyunca artroskopik omuz cerrahisi ağrısına bağlı ağrıyı ve postoperatif anksiyeteyi azaltabileceğini varsaydık.
Hastalar ve yöntemler: Bu prospektif, randomize, çift kör, plasebo kontrollü çalışmada, 65 uygun hasta rastgele iki gruba, preemptif pregabalin 150 mg (grup P) ve kontrol grubu (grup C) olarak ayrıldı. Birincil sonuçlar, görsel analog skalaya (VAS) dayalı olarak hem dinlenme hem de aktif hareket sırasında ölçülen ağrı seviyeleriydi. İkincil sonuçlar kaygı düzeyi (STAI-S ve STAI-T), hasta memnuniyeti ve komplikasyonlardı.
Bulgular: Grup P, kontrol grubuna göre daha düşük ağrı (p < 0.001), daha az opioid tüketimi (p < 0.001), ilk analjezi ihtiyacına kadar daha uzun süre (p < 0.001) ve daha düşük kurtarma analjezik dozu (p < 0.001) gösterdi. postoperatif 48 saat takip. Ayrıca grup P, grup C'ye göre daha az preoperatif ve postoperatif anksiyete (p < 0.001) ve daha fazla hasta memnuniyeti (p < 0.001) gösterdi. Postoperatif yan etkilerin oranı gruplar arasında benzerdi (p > 0.05).
Sonuç: Ameliyattan 2 gün önce günde 150 mg oral pregabalinin preemptif kullanımı, artroskopik cerrahi geçiren hastalarda hem istirahat hem de aktif harekette postoperatif analjezi sağladı ve preoperatif ve postoperatif anksiyete düzeylerini iyileştirdi ve hasta memnuniyetini artırdı.

Keywords

Analjezi, anksiyete, preemptif, pregabalin, ortopedik cerrahi

References

• Reference1. White PF. Pharmacologic and clinical aspects of preoperative medication. Anesth. Analgesia 1986;65:963-74.
• Reference2. Durkin B, Page C, Glass P. Pregabalin for the treatment of postsurgical pain. Expert Opin. Pharmacother. 2010;11:2751-8.
• Reference3. Guay DR. Pregabalin in neuropathic pain: a more “pharmaceutically elegant” gabapentin? Am J Geriatr Pharmacother 2005;3:274–87.
• Reference4. Ahn S, Byun SH, Park K, Ha JL, Kwon B, Kim JC. Analgesic efficacy of preemptive pregabalin administration in arthroscopic shoulder surgery: a randomized controlled trial. Can J Anesth/J Can Anesth 2016;63:283-89.
• Reference5. Mishriky B, Waldron, N, Habib A. Impact of pregabalin on acute and persistent postoperative pain: a systematic review and meta-analysis. Br. J. Anaesth. 2014;114:10-31.
• Reference6. Spielberger CD, Auerbach SM, Wadsworth AP, Dunn TM, Taulbee ES. Emotional reactions to surgery. J Consult Clin Psychol 1973;40:33-8.
• Reference7. Öner N, Le Compte A. Durumluk-Sürekli kaygı envanteri elkitabı, 20. Basım İstanbul: Boğaziçi Üniversitesi Yayınları. State-Trait Anxiety Inventory Handbook, 20th Edition Istanbul: Boğaziçi University Press, 1985. p.3-5. (Turkish).
• Reference8. Ilfeld BM, Morey TE, Wright TW, Chidgey LK, Enneking FK. Continuous interscalene brachial plexus block for postoperative pain control at home: a randomized, double-blinded, placebocontrolled study. Anesth Analg 2003; 96: 1089-95.
• Reference9. Eskandar AM, Ebeid AM. Effect of pregabalin on postoperative pain after shoulder arthroscopy. Egypt J Anaesth. 2013;29:363-7.
• Reference10. Bang SR, Yu SK, Kim TH. Can gabapentin help reduce postoperative pain in arthroscopic rotator cuff repair? A prospective, randomized, double-blind study. Arthroscopy. 2010;26:106-11.
• Reference11. Agarwal A, Gautam S ,Gupta D, Agarwal S, Singh PK, Singh U. Evaluation of a single preoperative dose of pregabalin for attenuation of postoperative pain after laparoscopic cholecystectomy. Br J Anaesth. 2008;101:700–704.
• Reference12. Esmat IM, Farag HM. Comparative study between paracetamol and two different doses of pregabalin on postoperative pain in laparoscopic cholecystectomy. Saudi J Anaesth. 2015;9:376–80.
• Reference13. Balaban F, Yagar S, Ozgok A, Koc M, Gullapoglu H. A randomized placebo-controlled study of pregabalin for postoperative pain intensity after laparoscopic cholecystectomy. J Clin Anesth. 2012;24:175–8.
• Reference14. Akhavanakbari G, Entezariasl M, Isazadehfar K, Mirzarahimi T. The effects of oral pregabalin on postoperative pain of lower limb orthopedic surgery: A double blind, placebo controlled trial. Perspect Clin Res. 2013;4:165- 68.
• Reference15. Caumo W, Schmidt AP, Bergmann J. Risk factors for preoperative anxiety in adults. Acta Anaesthesiol Scand 2001;45:298-307.
• Reference16. Shimony N, Amit U, Minz B, et al. Perioperative pregabalin for reducing pain, analgesic consumption, and anxiety and enhancing sleep quality in elective neurosurgical patients: a prospective, randomized, double-blind, and controlled clinical study. J Neurosurg 2016;125:1513-22.
• Reference17. Kindler CH, Harms C, Amsler F, Ihde-Scholl T, Scheidegger D. The visual analog scale allows effective measurement of preoperative anxiety and detection of patients' anesthetic concerns. Anesth Analg 2000;90:706-12.
• Reference18. Kim WS, Byeon GJ, Song BJ, Lee HJ. Availability of preoperative anxiety scale as a predictive factor for hemodynamic changes during induction of anesthesia. Korean J Anesthesiol 2010;58:328-33.
• Reference19. Domar AD, Everett LL, Keller MG. Preoperative anxiety: Is predictable entity? Anesth Analg 1989;69:763–70. Reference20. Demirkol MK, Tarhan F, Yazıcı O, Hamarat MB, Kafkaslı A. Evaluation of Preoperative Anxiety Level of Urological Surgery Patients and The Effects of Surgical Informing. South. Clin. Ist. Euras. 2019;30:337-342.
• Reference21. Demir A, Akyurt D, Ergün B, Haytural C, Yiğit T, Taşoğlu İ et al. Anxiety therapy in cardiac surgery patients. Turkish Journal of Thoracic and Cardiovascular Surgery. 2010;18:177-182. (Turkish)
• Reference22. Arlı SK. Evaluation of the Preoperative Anxiety With Apais and STAI-I Scales. Journal of Hacettepe University Faculty of Nursing. 2017;4:38-47. (Turkish)
• Reference23. Schwarzer R. Anxiety (Internet). 2020. Available from http:// www.macses.ucsf.edu/research/psychosocial/anxiety.php, Accessed May 26, 1997
• Reference24. Yücel A, Özturk E, Aydogan MS et al. Effects of 2 Different Doses of Pregabalin on Morphine Consumption and Pain After Abdominal Hysterectomy: A Randomized, Double-Blind Clinical Trial. Current Therapeutic Research. 2011;72:173-83.
• Reference25. Myles PS, Williams DL, Hendrata M, Anderson H, Weeks AM. Patient satisfaction after anaesthesia and surgery: results of a prospective survey of 10811 patients. Br J Anaesth 2000;84:6-10.
• Reference26. Dexter F, Aker J, Wright WA. Development of a measure of patient satisfaction with monitored anesthesia care: the Iowa Satisfaction with Anesthesia Scale Anesthesiology. 1997;87:865-73.
• Reference27. George RB McKeen DM Andreou P Habib AS A randomized placebo-controlled trial of two doses of pregabalin for postoperative analgesia in patients undergoing abdominal hysterectomy. Canadian Journal of Anaesthesia. 2014;61:551-7.
• Reference28. Gajraj NM. Pregabalin: its pharmacology and use in pain management. Anesth Analg 2007;105:1805-15.