![]() | Only 14 pages are availabe for public view |
Abstract Summary External dacryocystorhinostomy (DCR) remains the gold standard for lacrimal surgery. It is a bypass procedure that creates an anastomosis between the lacrimal sac and the nasal mucosa via a bony ostium through an external skin incision. External DCR can be completed under either local or general anesthesia. The DCR is a painful surgical procedure that involves intra-and extra-ocular dissection, with a high incidence post-operative nausea and vomiting (PONV). So, it is necessary to ensure a stress-free peri-operative period with adequate pain relief anda low incidence of PONVafter DCR surgery. Pregabalin is a lipophilic gamma-amino-butyric acid (GABA) analoguethat binds to the voltage-gated calcium channels.It reduces the excitability of the dorsal horn neurones after tissue damage. It has anticonvulsant, anxiolytic and sleep-modulating properties. It was shown to be effective in several models of neuropathic pain, incisional injury, and inflammatory injury. Preoperative administration of pregabalin, is proposed to be a promising way of enhancing postoperative pain control,reduction in postoperative opioidconsumption. The aim of this study wasto evaluate the effects of preoperative oral pregabalin on postoperative painand analgesic requirementsin patients undergoing dacryocystorhinostomy(DCR) surgery. This prospective randomized double-blind clinical study included 100 ASA I and II patients, aged between 40 and 65 years old of both genders who were scheduled for elective DCR surgery under general anaesthesia Mansoura University opthalomology center from January 2020 to June 2020. Informed written consents were obtained from all subjects in the study after ensuring confidentiality. Exclucion criteria were mental, psychological or neurological disorders, patients with history of durg or alcohol abuse, history of know sensitivity to the used durgs, bleeding or coagulation diathesis, obese patients (BMI < 35), pregnancy and lactation, patients who refused to participate in the study. Eligible 100 patients were randomly allocated to two equal groups (n=50 in each group) using a computer-generated randomization schedule into two groups:- • group (Pregabalin) (n=50): patients received two capsules of pregabalin (Lyrica 150 mg capsule, Pfize, Freiburg, German) one at the night of the surgery, and the other 2 hours before the surgery. • group (Control) (n=50): patients received two identical placebo capsules. The current study showed that pain score measured by visual analogue score (VAS) showed statistically significant differences immediately on arrival to PACU, 1h at PACU, later at 2 h up to 24h post-operatively between the two studied groups. It was statistically significantly lower in pregabalin group. The time for the first request analgesia statistically significant in pregabalin group when compared to placebo group. Total postoperative pethedine consumption in the first 24h was significantly lower in pregabalin group when compared to placebo group. Number of pateints with nausea was statistically significant lower in pregabalin group as compared to placebo group without any other significant in number of vomiting or total antiemetic dose of ondanseterone between the two groups. In conclusion : It was concluded that preoperative administration of pregablain is proposed to be a promising way of enhacing postoperative pain control and reduction in postoperative opioid consumption. |