A prospective comparative evaluation of gabapentin vs pregabaline for the acute post-operative pain management in lower limb surgeries under spinal anaesthesia

S. Ramakrishna, C. Agarwal
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Abstract

Background: Pre emptive analgesia is multimodal approach where drug is used before surgery and has potential to be more effective than a similar analgesic treatment initiated after surgery. Pregabaline and Gabapentin are GABA analogue used is used as pre-emptive analgesic. Its analgesic action is mediated through α2δ subunit of voltage gated calcium channels on dorsal horn neurons. Material and Method:96 patients satisfying selection criteria were enrolled for this study and divided in to three groups Group P, Group G and Group C each having 32 patients. All patients were explained about visual analogue score. Result: There is significant difference between three groups regarding time of first rescue analgesia and tramadol consumption. The mean time for rescue analgesia was longer in pregabaline group then gabapentin group (482.7±113.5 min vs 343.35±70.74 min). The mean amount of dose of tramadol requirement was also less in pregabaline and gabapentin group (164.32±39.41 vs178.32±48.21 vs 272.82±83.01) in comparison control. Conclusion: The VAS score was significantly higher in control then pregabaline and gabapentin group. Both pregabaline (group P) and gabapentin (group G) are comparable to each other regarding VAS score at different time interval in post operative period. Ramsay sedation score was significantly higher in pregabaline and gabapentin group up 4 hour post operatively but after that there was no significant difference between two groups. Both pregabaline (group P) and gabapentin (group G) are comparable to each other regarding Ramsay sedation score at different time interval in post operative period.
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加巴喷丁与普瑞巴林在脊柱麻醉下下肢手术后急性疼痛管理中的前瞻性比较评价
背景:先发制人的镇痛是一种多模式的方法,在手术前使用药物,可能比手术后开始的类似镇痛治疗更有效。普瑞巴林和加巴喷丁是GABA类似物,被用作先发制人的镇痛药。其镇痛作用是通过背角神经元电压门控钙通道α2δ亚基介导的。材料与方法:入选96例符合入选标准的患者,分为P组、G组和C组,每组32例。对所有患者进行视觉模拟评分。结果:三组患者首次抢救镇痛时间及曲马多用量差异有统计学意义。普瑞巴林组抢救镇痛的平均时间较加巴喷丁组长(482.7±113.5 min vs 343.35±70.74 min)。普瑞巴林加巴喷丁组曲马多的平均需药量(164.32±39.41 vs178.32±48.21 vs 272.82±83.01)也低于对照组。结论:对照组VAS评分明显高于普瑞巴林加巴喷丁组。普瑞巴林(P组)和加巴喷丁(G组)术后不同时间间隔的VAS评分具有可比性。普瑞巴林组和加巴喷丁组术后4 h Ramsay镇静评分显著高于对照组,术后无显著差异。P组普瑞巴林与G组加巴喷丁在术后不同时间间隔的Ramsay镇静评分具有可比性。
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