Effect of pregabalin and dexamethasone on postoperative analgesic requirement in middle ear surgery

Background: Pain is one of the most important cause of delayed discharge after day care surgery, side effects of opioid lead to development of multimodal approach for post operative pain control. In this study we aimed at evaluating the effect of preemptive pregabalin and dexamethasone on pain scores and analgesic requirements in middle ear surgery.
Methods: Total 90 patients were randomized into three groups in a double blinded as:
Group I: Patients received oral Pregabalin capsule (300 mg) and Dexamethasone
8mg IV.
Group II: Patients received oral Pregabalin capsule (300 mg) and IV placebo.
Group III: Patients received oral placebo capsule and IV placebo.
Patients were examined for pain scores during first 24 hours postoperatively, total rescue analgesia and adverse events. Parametric data were analysed using ANOVA test. Non parametric data were analysed with chi square test.
Result: The demographic data were comparable with respect to age, BMI, ASA status, type and duration of surgery. Rescue analgesia was required earliest in Group III followed by that in Group II and last in Group I. Number of rescue doses required by patients of Group I & II (p=0.003) and between Group I & Group III (p<0.001) were found to be statistically significant. Incidence of sedation was higher in Group II (36.67%) and Group I (33.33%) and was found to be statistically significant (p=0.039). Incidence of nausea was higher in Group III (36.67%) and Group II (30.00%) as compared to Group I (6.67%) and was found to be statistically significant (p=0.018).
Conclusion: In this prospective study, oral pregabalin 300 mg with i.v. dexamethasone 8 mg administered before operation was significantly effective in reducing postoperative pain and postoperative analgesic requirement in patients undergoing modified radical mastoidectomy surgery. Use of pregabalin resulted in sedation in early postoperative period, but the patients were easily arousable and dexamethasone resulted in decreased incidence of nausea.