Evaluation of Oral Pregabalin Premedication for Attenuation of Haemodynamic Response during Tracheal Intubation in Adult Patients with Controlled Hypertension For Elective Surgery

Surabhi  Sandill; Mhonchumi  Khuvung; Rajpal  Singh; Udismita  Baruah

doi:10.18502/aacc.v10is2.17216

Surabhi Sandill Department of Onco-Anaesthesia and Palliative Medicine, Dr. B.R.A.I.R.C.H., AIIMS, New Delhi, India.
Mhonchumi Khuvung Department of Anaesthesia, CIHSR, Dimapur, Nagaland, India.
Rajpal Singh Department of Anaesthesia and Critical Care, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
Udismita Baruah Department of Anaesthesia and Critical Care, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.

DOI: https://doi.org/10.18502/aacc.v10is2.17216

Keywords: Pregabalin; Controlled hypertension; Tracheal intubation; Haemodynamic response

Abstract

Background: The laryngoscopy and tracheal intubation is a noxious stimuli resulting in transient but marked sympathetic response. This response is exaggerated in patients with hypertension. This study evaluated the role of oral pregabalin premedication in attenuation of haemodynamic response during tracheal intubation in adult patients with controlled hypertension posted for elective surgery.

Methods: A prospective double blinded randomized study was carried out in a total of 60 adult patients (aged 18-65 years, either gender) with controlled hypertension after being randomized into two groups with 30 patients in each. Prior to induction, Group PL received Placebo (multivitamin) and Group PB received pregabalin 75mg tablet 1 hour. The anaesthesia technique was standardized as per department protocols. Both groups were evaluated for pre-operative sedation, haemodynamic changes after premedication, before and after induction, after the laryngoscopy and tracheal intubation and post-operative side effects.

Results: There was attenuation of haemodynamic responses without significant side effects with pregabalin. Statistically significant increase in post intubation systolic, diastolic and mean blood pressure was seen in group PL as compared to group PB. In both groups, a reduction in heart rate was observed and was statistically significant 1 minute after intubation in group PB. Pre-operative sedation levels were higher in PB group in comparison to PL group. No post-operative side effects observed in both the groups.

Conclusion: In controlled hypertensive patients, oral pregabalin 75 mg attenuated the haemodynamic responses to laryngoscopy and tracheal intubation. It produced effective pre-operative sedation without any post-operative side effects.