Comparison of the Effect of Two Different Doses of Oral Pregabalin in Reducing Postoperative Analgesia in Patients Receiving Neuraxial Anaesthesia for Surgical Procedures: A Randomised Controlled Trial

Introduction: Effective postoperative pain management is vital for patient recovery and comfort. Due to the side effects associated with opioids, alternative strategies such as Pregabalin are being explored. As a Gamma-aminobutyric Acid (GABA) analogue, Pregabalin may reduce pain and analgesic requirements by modulating central sensitisation. The present study evaluates the impact of preoperative oral Pregabalin on enhancing subarachnoid block, prolonging postoperative analgesia and improving recovery in patients undergoing neuraxial surgeries. Aim: To evaluate the efficacy of oral Pregabalin (150 mg and 300 mg) compared with a placebo in reducing postoperative pain in patients undergoing surgical procedures under spinal anaesthesia. Materials and Methods: The present double-blinded randomised controlled trial was conducted in the Department of Anaesthesiology at SRM Medical College Hospital and Research Centre, Chennai, Tamil Nadu, India, from September 2024 to February 2025 over a duration of six months. After obtaining written consent, 90 patients undergoing surgery under neuraxial blockade were recruited and randomised into three groups. The study drugs were administered one hour before surgery as follows: Group C (Placebo drug), Group P1 (T. Pregabalin 150 mg), Group P2 (T. Pregabalin 300 mg). The Ramsay Sedation Scale was used to assess sedation levels before and after the procedure. Pain intensity was assessed using the Visual Analogue Scale (VAS). Statistical analysis was performed using Statistical Packages of Social Sciences (SPSS) software (version 26.0), with a significance level set at 0.05. Results: There was no statistically significant difference in the demographic characteristics of the study participants, such as age, height and weight (Mean=40.01 years, 166.42 cm, 67.3 kg; p=0.537, 0.454, 0.349, respectively). The time to first analgesic requirement after spinal anaesthesia was significantly longer in patients who received pregabalin compared with those who received the placebo (Mean=105.83, 120.33, 126.67 minutes, respectively; p<0.001). Corresponding VAS scores at the time analgesia was administered were also statistically significant (Mean=4.04, 3.08, 2.99, respectively; p<0.001). Conclusion: Compared with placebo, preoperative oral pregabalin was effective in enhancing sedation, delaying the onset of postoperative pain and reducing the need for early rescue analgesics.