title: Gabapentin vs pregabalin as a premedication in lower limb orthopaedics surgery under combined spinal epidural technique.
abstract: BACKGROUND
  Pregabalin and gabapentin are the gamma-aminobutyric acid analogs used as a part of multimodal analgesic regimen.
  
  
  OBJECTIVE
  To compare the postoperative analgesic benefits of gabapentin or pregabalin as a premedication for lower limb orthopedic surgery under combined spinal-epidural techniques.
  
  
  METHODS
  Randomized double-blind study.
  
  
  METHODS
  A total of 90 patients were divided into three groups: G, P, C who received gabapentin 1200 mg, pregabalin 300 mg, and placebo, respectively 1.5 h before surgery. All patients received combined spinal-epidural block with 3 ml of 0.5% intrathecal bupivacaine. Assessment of pain was made with visual analog scale (VAS). Postoperative analgesia was provided with epidural top-ups with 2.5 ml of 0.5% bupivacaine and fentanyl 25 μg when VAS >3. Rescue analgesia in the form of injection diclofenac (75 mg) intramuscularly was given if VAS >3 even after epidural top-up. A total number of epidural top-ups, rescue analgesia, pain-free interval postspinal anesthesia, and sedation score were noted.
  
  
  METHODS
  This was done using SPSS version 17. Mean and standard deviation were calculated using Chi-square test and analysis of variance.
  
  
  RESULTS
  The total postoperative analgesic time was 7.23 h in Group G, 14.80 h in Group P, and 4.17 h in Group C. A total number of epidural top-ups were 2.43 in Group G, 0.77 in Group P, and 4.43 in Group C.
  
  
  CONCLUSIONS
  Pregabalin 300 mg and gabapentin 1200 mg significantly reduce the need of postoperative rescue analgesia, epidural top-ups, and increase the duration of postspinal anesthesia without altering hemodynamics with sedation as a major side effect.
authors.affiliation: Department of Anesthesia, Government Medical College, Amritsar, Punjab, India.
authors.forename: Ranjana
authors.initials: R
authors.lastname: Khetarpal
authors.affiliation: Department of Anesthesia, Government Medical College, Amritsar, Punjab, India.
authors.forename: Amar Parakash
authors.initials: AP
authors.lastname: Kataria
authors.affiliation: Department of Anesthesia, Government Medical College, Amritsar, Punjab, India.
authors.forename: Samita
authors.initials: S
authors.lastname: Bajaj
authors.affiliation: Department of Anesthesia, Government Medical College, Amritsar, Punjab, India.
authors.forename: Harjinder
authors.initials: H
authors.lastname: Kaur
authors.affiliation: Department of Anesthesia, Government Medical College, Amritsar, Punjab, India.
authors.forename: Sudha
authors.initials: S
authors.lastname: Singh
keywords: Diclofenac; gabapentin; gamma-aminobutyric acid; pain; pregabalin; visual analog scale