Recently, many studies have investigated the pre-emptive analgesia of pregabalin for various types of surgery with varying results. Pre-emptive analgesia in cesarean section (SC) usually utilizes pregabalin at a dose of 150 mg; however, no studies have described using low doses (75 mg).

A recent study determined the effects of pregabalin 75 mg vs. 150 mg doses for controlled pain and their sedation score in patients after C-section under spinal anesthesia. 

The study included 20 samples of patients who underwent elective C-sections under spinal anesthesia and randomized them into two equal groups: P75 (received oral pregabalin 75 mg) and P150 (received pregabalin 150 mg). 

It found no significant differences in the Numeric Rating Scale (NRS) between the 75 vs. 150 mg group but found significant differences in Ramsays sedation score between the 75 vs. 150 mg group on 2 and 6 hours after surgery. Further, there were no significant differences in the need for fentanyl rescue between the 75 vs. 150 mg group. 

Pregabalin has an opioid-sparing effect, and its larger doses may increase efficacy. Its sedative effect is due to the mechanism of action of pregabalin which binds potently to the 2δ subunit calcium channel and modulates calcium influx at nerve endings, thus reducing the release of several excitatory neurotransmitters (glutamate), such as the mechanism of action of various intravenous and inhaled anesthetic agents. 

Thus, this study recommends a Preemptive administration of pregabalin 75 mg for C-section surgery because it might reduce NRS and the need for fentanyl rescue with minimal sedation side effects.

Jurnal Kesehatan. 2022;15(1). DOI: https://doi.org/10.24252/kesehatan.v15i1.27762