A comparative study of intravenous fentanyl, oral pregabalin, and a combination of both for attenuation of hemodynamic response to laryngoscopy and tracheal intubation

Background Responses due to laryngoscopy and endotracheal intubation have an effect on blood pressure, heart rate, catecholamines, and oxygen demand of myocardium. These transient changes may affect those with known cardiovascular disease. Very few studies are available comparing fentanyl and pregabalin for attenuation of pressor response to laryngoscopy and intubation. Objective Evaluation and comparing the efficacy of oral pregabalin and intravenous fentanyl and combination of both for attenuation of pressor response to laryngoscopy and intubation. Materials and Methods This was a single-center, hospital-based, randomized, open-label trial. Ninety patients were randomly allocated into one of three groups. F-Group patients received 2 μg/kg of fentanyl intravenously 5 min before induction. P-Group patients received orally 150 mg capsule of pregabalin 1 h before induction. B-Group patients received a combination of both oral pregabalin 150 mg, 1 h before induction and intravenous fentanyl 2 μg/kg, 5 min before induction. Results The patients from three groups were comparable for baseline characteristics (P > 0.05). At all-time intervals the mean heart rate was significantly lesser in fentanyl + pregabalin group compared to fentanyl group and pregabalin alone group (P < 0.05). Mean systolic blood pressure at 4 min, 5 min was significantly lower in fentanyl+pregabalin group. Mean diastolic blood pressure was significantly lower in the pregabalin group patients and also the fentanyl+pregabalin group as compared to the fentanyl alone group patients at 4 min (P < 0.05). Mean arterial pressure at 4 and 5 min was significantly lower in fentanyl+pregabalin group and pregabalin group (P < 0.05). Conclusion A combination of intravenous fentanyl in the dose of 2 μg/kg 5 min before induction and oral pregabalin in the dose of 150 mg 1 h before induction works very well in attenuating the hemodynamic response to laryngoscopy and endotracheal intubation compared to either intravenous fentanyl or oral pregabalin alone.