Author(s): Bhavani Muthukrishnan1, Murugan Thalaippan2
The stress response to surgery is characterised by increased secretion of pituitary hormones and activation of the sympathetic nervous system. The changes triggered by the stress response are short-lived and well tolerated by normal healthy patients belonging to ASA 1 and 2. In patients with other comorbidities like myocardial ischaemia, renal insufficiency, uncontrolled diabetes, liver disease and cerebrovascular diseases, these changes can be life threatening. The recognition of the factors which initiate the stress response can be considered for modification in the preoperative period itself. Various anaesthetic techniques and pain management strategies have been put into use to control the stress response.
To study the rise in serum cortisol levels during surgery after administering oral pregabalin as a premedicant.
SETTINGS AND DESIGN
A Prospective Randomised Placebo Controlled Study.
MATERIALS AND METHODS
All consented patients were aged between 18 and 50 years belonging to ASA 1 & 2 undergoing elective surgical procedures under general anaesthesia of duration between 30 minutes and 180 minutes. Group A received oral placebo, Group B oral pregabalin 150 mg 60-90 minutes before surgery with sips of water. They were randomly allocated to a particular group using computer generated numbers. The ward staff nurse administered the drug kept in sealed envelopes. Both the patients and the person administering anaesthesia were unaware of the group.
The results were analysed using SPSS Version 17 software with the help of the statistician. The students’ paired t-test was used to compare the mean change in the cortisol levels in the two groups.
There was a significant [p < 0.01] reduction in the intraoperative cortisol levels after premedication with pregabalin. There was an increase in serum cortisol levels after extubation in both the groups which was statistically significant (p < 0.01).
Pregabalin in the dose of 150 mg given per orally one hour before elective surgeries can attenuate the neuroendocrine stress response due to induction and intubation. Better surgical skills and techniques have got a major role in attenuating neuroendocrine stress response more than the conventional anaesthetic interventions.