Pregabalin renders good postoperative analgesia in nociceptive stimuli. Evidence indicates that preemptive oral pregabalin decreases acute postoperative pain. A recent study evaluated the efficacy of 2 different doses of pregabalin and its effect on the onset and duration of spinal anesthesia and postoperative pain.

The study recruited 60 patients posted for vaginal hysterectomy under spinal anesthesia and randomized them into two groups to receive either cap. Pregabalin 75 mg (group 1) and cap pregabalin 150 mg (group 2) orally, 90 min before surgery. It recorded the Onset and duration of motor and sensory blockade and also assessed Postoperative pain by VAS for 24 hrs. 

Injection paracetamol 1 gm. was given intravenously as a rescue analgesic. Finally, the time of the first rescue analgesic and total dose of rescue analgesics was recorded.

The results indicated that Group 2 patients experienced better postoperative analgesia concerning prolonged sensory and motor blockade which correlated well with the time of the first request for rescue analgesia (504±123.2 min) than group 1 patients (304.9±37.6 min). Also, the total dose of rescue analgesic (paracetamol) was markedly less with 150mg pregabalin.

Thus, Pregabalin 150 mg stretches the duration of spinal anesthesia and shows a better analgesic profile without significant side effects; and when given preemptively can optimize spinal anesthesia well in patients for vaginal hysterectomy.

Panse N, Adate K, Panchal S. Comparative Evaluation of Two Different Doses of Pre-Emptive Oral Pregabalin on Duration of Spinal Anesthesia and Postoperative Pain. Arch Anesth & Crit Care. 2021;7(2):75-81.