Background: Laryngoscopy and intubation is a noxious stimulus, which can provoke many untoward responses, particularly in the cardiovascular system in the form of hypertension, tachycardia, and dysrhythmia, which can be detrimental in cardiovascular compromised patients. For decreasing anxiety and the intubation response, use of nonopioid drugs has become a part of the multimodal regimen. Many recent studies show that drugs such as gabapentin and pregabalin are known to decrease stress response due to laryngoscopy and intubation.
Objective: To evaluate the effect of different doses of pregabalin as oral premedication to attenuate cardiovascular response during laryngoscopy and endotracheal intubation.
Patients and methods: The study included 120 normotensive normoglycemic patients undergoing abdominal hysterectomy who were randomly divided into 4 equal groups: group A received a placebo drug, groups B, C and D received different doses of oral pregabalin (75 mg, 150 mg and 300 mg respectively). The patients were unaware of their group distribution. Patients were carefully selected regarding the demographic data and the medical status. The anesthetic technique included preoperative assessment and preparation, during which the patients were informed about the details of the study, gave their consent, learned how to use VAS, and received the drug of the study. This study was done at Al-Azhar University Hospitals after approval of the medical ethical committee, from December 2019 till July 2021.
Results: There was no significant difference between groups as regards demographic data, duration of intubation or duration of surgery. There were increase in hemodynamic values during intubation compared to the baseline values in all groups. However, the increase in both groups C and D was less than that of groups A and B. Afterwards, there was a gradual decrease in the hemodynamic parameters at 1, 3 and 5 minutes after intubation in all groups. Intraoperative fentanyl consumption decreased in the current study on using pregabalin in doses of 150 mg and 300 mg. A dose of 75 mg did not show such effect. Blood cortisol level decreased in the current study on using pregabalin in doses of 150 mg and 300 mg.
Conclusion: Pregabalin in doses of 150 and 300 mg attenuated the hemodynamic response to laryngoscopy and endotracheal intubation, and decreased the requirement of post-operative analgesia.