Application of Pre-emptive analgesia strategy for operative procedures
saad, A.*
ahamdi hospital, anesthesia, ahamdi, Kuwait
ESRA Academy. Saad A. Sep 13, 2017; 190722; 508 Topic: PAIN THERAPY (ACUTE - CHRONIC)
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Background and Aims:

Pain from surgical procedures occurs as a consequence of tissue trauma and may result in physical, cognitive, and emotional discomfort.  Pre-emptive analgesia focuses on postoperative pain control and the prevention of central sensitization and chronic neuropathic pain by providing analgesia administered preoperatively but not after surgical incision.
--aim; To study the effect of oral gabapentin used as preemptive analgesia to attenuate post operative pain


In a randomized double blind study, 40 patients were given Lyrica 75 mg 2hr preop +/- Celebrex 200mg PO CAP. 2hr preop. +/- zantac 150mg PO tab. 2hr preoperative then postoperative; Lyrica 75 mg at night HS + Celebrex 200mg PO CAP. BD +/- Solpadine 2tab. QID post. Op

Combined with regional anaesthesia (spinal/epidural), intraoperative local anaesthetic infiltration and some slow release post operative analgesia, my experience is that patients are more comfortable post op, able to mobilise much quicker and achieve an earlier and more comfortable discharge from hospital.


Time for rescue analgesia (VAS score >3) was significantly increased in most patients given lyrica preoperative and postoperative with NSAIDs. The sedation scores and patient satisfaction scores were also more with Lyrica, NSAIDs.


Preemptive pregabalin in an oral dose of 75-150mg offers good postoperative analgesia in lower limb orthopedic surgeries under spinal anesthesia. pre-emptive oral pregabalin reduces diclofenac requirement post-operatively which was significantly lower as compared to placebo group. single dose preoperative pregabalin improves analgesia in early postoperative period and reduces analgesic consumption but with increased sedation without respiratory depression. use of narcotics less after preemptive protocol

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