CNS Update: Preoperative High-dose and Low-dose Pregabalin and Cardiovascular Response to Endotracheal Intubation


eMediNexus    14 December 2022

A prospective, randomized clinical study evaluated the efficacy and tolerability of preoperative pregabalin on cardiovascular response to laryngoscopy and endotracheal intubation.


The study recruited patients aged 18–60 years with an American Society of Anesthesiologists scale score of I or II and randomized them to receive placebo (control), low-dose (150-mg) pregabalin, or high-dose (300-mg) pregabalin. The patients received the oral dose of medications 1 hour before general anesthesia. They were assessed for Heart rate, systolic and diastolic blood pressures, and mean arterial blood pressure before medication, before endotracheal intubation, and at 0, 1, 3, 5, 7, and 10 minutes after intubation. Further, their sedation score was recorded 1 hour after administering the placebo or pregabalin.


The findings of the study were as follows-

  • The study enrolled 90 patients (n = 30 per group). 
  • Pregabalin (150 or 300 mg) therapy caused reduced blood pressure fluctuations after intubation, without any significant differences between the two dose groups. 
  • Pregabalin caused an inhibitory effect on heart rate fluctuations and reduced hemodynamic complications after intubation in a dose-dependent manner. However, it did not affect the required perioperative opioid dosage. 
  • Both doses of pregabalin effectively reduced preoperative anxiety; however, they reduced visual analog scale pain scores 1 hour after surgery only in limb and spine, and abdominal surgeries. 
  • Both pregabalin groups showed adverse reactions as dizziness 1 hour after surgery.


Thus this study shows that high-dose (300-mg) pregabalin can effectively attenuate cardiovascular response after endotracheal intubation.


Clinical Therapeutics. 2019;41(1):68-77. https://doi.org/10.1016/j.clinthera.2018.11.006.

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