Comparative Study between Oral Pregabalin versus Intravenous Low Dose Ketamine for Post-Operative Pain Management in Laminectomy

Abstract

Background: Lumbar laminectomy is accompanied with significant post-operative pain. Preemptive analgesia is effective to reduce the magnitude and duration of post-operative pain. Aim of Study: The aim of this study is to compare the efficacy of oral pregabalin versus IV low dose ketamine for postoperative pain management in patients undergoing elective single level lumbar laminectomy. Material and Methods: This prospective double blind randomized controlled study was carried out on 105 patients of both sexes, 18-60y, American Society of Anesthesiologist I or II and scheduled for elective single level lumbar laminectomy under general anaesthesia. All patients are randomly allocated into 3 equal groups: Control group (received a placebo capsule orally 1h before induction of anesthesia and 5ml normal saline Intravenous (IV) before induction of anesthesia). Pregabalin group: Received a 150mg pregabalin capsule orally 1h before induction of anesthesia and 5ml normal saline IV before induction of anesthesia and ketamine group: Received a placebo capsule orally 1h before induction of anesthesia and 0.3mg/kg ketamine in 5ml of normal saline syringe IV before induction of anesthesia. Visual Analogue Scale (VAS), Heart Rate (HR) & Mean Arterial Pressure (MAP) were recorded at 30min, 2h, 4h, 6h, 12h, 18h and 24h post-operative, the time (h) to first analgesic requirement, total dose of rescue analgesia (morphine) were recorded. Sedation scores & complications were measured. Results: Our results showed no significant difference as regard to age, sex, weight & ASA physical status, but there was significant decrease in VAS. 1 st analgesic requirements & total dose of rescue analgesia in pregabalin group & ketamine group as compared to control group with ( p<0.05) & pregabalin group was superior to both groups as regard sedation score. Conclusion: Pre-operative administration of oral pregabalin (1 50mg) 1h before surgery or IV ketamine at dose Correspondence to: Dr. Ahmed G. Arakeeb, The Department of Anesthesiology and Surgical Intensive Care, Faculty of Medicine, Tanta University (0.3mg/kg) at induction in patients undergoing elective singlelevel lumbar laminectomy significantly decreased postoperative pain, total opioid consumption as compared with control group without significant side effects.