A recent study compared pregabalin and midazolam premedication in pediatric day-case surgery concerning anesthetic and analgesic requirements.

It included 60 patients who were scheduled for day-case surgery and randomized them to oral premedication with either pregabalin (Group P) or midazolam (Group M). The primary outcomes were assessment of Intraoperative anesthetic and analgesic requirements by measuring the Modified Ramsay Sedation Score (RSS), hemodynamic variables, time to eye-opening, and time to extubation after the termination of general anesthesia. Secondary outcomes were the measurement of Post-anesthesia care unit (PACU) duration of stay, postoperative Pediatric Anesthesia Emergence Delirium (PAED) scale, and Faces Legs Activity Cry Consolability (FLACC) scale, and post-operative analgesic needs. 

The results showed no significant differences between the studied groups regarding types and duration of surgery, preoperative modified RSS, and postoperative PAED. Group P displayed significantly lower-

• mean ranks of sevoflurane and fentanyl consumption,
• means of heart rate and arterial blood pressure following induction of anesthesia,
• mean rank in Postoperative FLACC pain score,
• need for rescue analgesics,
• mean ranks of rectal diclofenac and meperidine consumption
• duration of stay in PACU 
• time to open the eye and to extubate

both groups showed comparable mean ranks of total paracetamol doses. Group P showed a significantly higher time to first analgesic requirement.

Thus, Pregabalin can significantly reduce the perioperative anesthetic and analgesic requirements, the PACU duration of stay, and the time to open the eye and to extubate than midazolam. Hence, it is recommended to use Pregabalin as a premedication in pediatric day-case surgery.

Egyptian Journal of Anaesthesia. 2021;37(1):50-56. DOI: 10.1080/11101849.2021.1878687