Study to determine the effect of oral pregabalin premedication on haemodynamic response to laryngoscopy, intubation and carbon dioxide insufflation during laparoscopic cholecystectomy

Harikrishna Allu, Malavika Kulkarni, Ekambaram Dinesh

Research output: Contribution to journalArticle

Abstract

Background: The process of laryngoscopy and endotracheal intubation is usually associated with exaggerated haemodynamic response. In extreme cases this response may result in myocardial ischaemia, cardiac failure, increase in intracranial pressure and intracranial haemorrhage. Hence our prospective randomized double blinded placebo control study was designed to observe the effect of pregabalin in attenuating this haemodynamic response. Method: In this study, 100 adult patients of ASAPS I and II undergoing elective laparoscopic cholecystectomy were included. The patients were randomly allocated into two groups, group P received 150mg oral pregabalin and group C received similarly looking B complex capsules one hour before the surgery. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP) were observed. Sedation score was assessed using Ramsay sedation scale. Results: We observed an increase in all the haemodynamic parameters in both the groups. The percentage change in HR and MAP from baseline at one-minute following intubation was +33% and +28.5% in control group compared to +14% and +3% in pregabalin group. Similarly, the percentage change at five minutes after carboperitoneum was +24% and +26% in control group compared to +4% and +0.8% in pregabalin group. This difference was statistically significant with P value <0.05. We also found all the patients in acceptable sedation state (score 3 and 4 based on Ramsay sedation scale) in pregabalin group whereas only 40% patients had a score of 3 in placebo group at 15minutes following extubation. Conclusion: Oral pregabalin in a dose of 150mg one hour before the surgery is a safe and effective premedicant in attenuating pressor response to laryngoscopy, intubation and laparoscopy. It also produces good sedation without any adverse effects.

Original languageEnglish
Pages (from-to)8-14
Number of pages7
JournalSri Lankan Journal of Anaesthesiology
Volume27
Issue number1
DOIs
Publication statusPublished - 06-02-2019
Externally publishedYes

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Insufflation
Laryngoscopy
Premedication
Laparoscopic Cholecystectomy
Intubation
Carbon Dioxide
Hemodynamics
Blood Pressure
Arterial Pressure
Heart Rate
Placebos
Control Groups
Intracranial Hypertension
Intratracheal Intubation
Intracranial Hemorrhages
Laparoscopy
Capsules
Myocardial Ischemia
Pregabalin
Heart Failure

All Science Journal Classification (ASJC) codes

  • Anesthesiology and Pain Medicine

Cite this

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title = "Study to determine the effect of oral pregabalin premedication on haemodynamic response to laryngoscopy, intubation and carbon dioxide insufflation during laparoscopic cholecystectomy",
abstract = "Background: The process of laryngoscopy and endotracheal intubation is usually associated with exaggerated haemodynamic response. In extreme cases this response may result in myocardial ischaemia, cardiac failure, increase in intracranial pressure and intracranial haemorrhage. Hence our prospective randomized double blinded placebo control study was designed to observe the effect of pregabalin in attenuating this haemodynamic response. Method: In this study, 100 adult patients of ASAPS I and II undergoing elective laparoscopic cholecystectomy were included. The patients were randomly allocated into two groups, group P received 150mg oral pregabalin and group C received similarly looking B complex capsules one hour before the surgery. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP) were observed. Sedation score was assessed using Ramsay sedation scale. Results: We observed an increase in all the haemodynamic parameters in both the groups. The percentage change in HR and MAP from baseline at one-minute following intubation was +33{\%} and +28.5{\%} in control group compared to +14{\%} and +3{\%} in pregabalin group. Similarly, the percentage change at five minutes after carboperitoneum was +24{\%} and +26{\%} in control group compared to +4{\%} and +0.8{\%} in pregabalin group. This difference was statistically significant with P value <0.05. We also found all the patients in acceptable sedation state (score 3 and 4 based on Ramsay sedation scale) in pregabalin group whereas only 40{\%} patients had a score of 3 in placebo group at 15minutes following extubation. Conclusion: Oral pregabalin in a dose of 150mg one hour before the surgery is a safe and effective premedicant in attenuating pressor response to laryngoscopy, intubation and laparoscopy. It also produces good sedation without any adverse effects.",
author = "Harikrishna Allu and Malavika Kulkarni and Ekambaram Dinesh",
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Study to determine the effect of oral pregabalin premedication on haemodynamic response to laryngoscopy, intubation and carbon dioxide insufflation during laparoscopic cholecystectomy. / Allu, Harikrishna; Kulkarni, Malavika; Dinesh, Ekambaram.

In: Sri Lankan Journal of Anaesthesiology, Vol. 27, No. 1, 06.02.2019, p. 8-14.

Research output: Contribution to journalArticle

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