Source: DGNews  |  Posted 2 years ago

By Lexa W. Lee

NEW ORLEANS -- October 26, 2009 -- Preoperative pregabalin lowers morphine
consumption, the incidence of postoperative nausea and vomiting (PONV), and
visual analogue pain scores (VAS) in the first 24 hours after surgery in obese
patients who undergo bariatric surgery, according to a study presented here on
October 19 at the 2009 Annual Meeting of the American Society of
Anesthesologists (ASA).

Obese patients are known to have a low pain threshold; laparoscopic bariatric
surgery can result in moderate to severe postoperative pain. Since the use of
opioids as anaesthesia is associated with PONV and respiratory depression, the
researchers wanted to evaluate how these parameters might be affected by giving
preoperative pregabalin to obese patients before laparoscopic bariatric surgery.

According to Maria Carolina Cabrera Schulmeyer, MD, University of Valparaiso,
Santiago, Chile, pregabalin is known to decrease pain perception by binding to
specific calcium channels in the brain and spinal cord and reducing the release
of neurotransmitters.

For the double-blind, prospective, randomised study, 67 patients undergoing
laparoscopic bariatric surgery were divided into 2 groups. Mean weight was
104.5 kg. Two hours before surgery, a preoperative dose of pregabalin 150 mg
was given to 33 patients and 34 patients received a placebo tablet.

All patients received an intraoperative dose of morphine 0.1 mg
kg^-1, a 100-mg bolus of ketoprofen, and a 300-mg postoperative
infusion of ketoprofen. Hourly VAS and total morphine consumption were measured
during the first 24 hours after surgery.

Primary outcomes were the consumption of morphine during the 24-hour period
after surgery and the severity of postoperative pain. Secondary outcomes were
the incidence of PONV, dizziness, somnolence, sedation, and respiratory
depression.

Morphine consumption in the pregabalin group was 11.4 mg in 24 hours, and 23.5
mg in the control group (P < .0001). VAS scores were also
significantly lower in the pregabalin group; also, 10 pregabalin-treated
patients experienced PONV versus 19 placebo-treated patients (P <
.05), and antiemetic consumption was 21% lower in the pregabalin group.

The researchers concluded that 150 mg of pregabalin given 2 hours before
laparoscopic bariatric surgery is effective in decreasing morphine consumption,
PONV, and VAS in the first 24 hours after surgery in obese patients.

Presentation title: Analgesic Effects of Preoperative Pregabalin After
Laparoscopic Bariatric Surgery. Abstract A793