title: Dose ranging effects of pregabalin on pain in patients undergoing laparoscopic hysterectomy: A randomized, double blinded, placebo controlled, clinical trial.
abstract: OBJECTIVE
  The study aimed to investigate the preemptive analgesia efficacy of different concentrations (75, 150 and 300mg) of preemptive pregabalin for the postoperative pain management after laparoscopic hysterectomy.
  
  
  METHODS
  Prospective, randomized, placebo-controlled, double-blind study.
  
  
  METHODS
  The Gynecology and Obstetrics Center of Arash Hospital, Tehran, Iran, from October 2013 to November 2014.
  
  
  METHODS
  A total of 96 women with American Association of Anesthesiologist (ASA) physical status I and II underwent elective laparoscopic hysterectomy surgery. Patients were then randomly assigned to four groups, of which groups 1-3 (treatment groups; n=20) received orally pregabalin concentrations of 75mg, 150mg, and 300mg, respectively, for a night before surgery, 30min before surgery and 6h after surgery, whereas group 4 (control group; n=22) received a matching dosage of placebo at the same scheme.
  
  
  METHODS
  Visual Analog Scale (VAS) scores for postoperative pain at rest and on movement at first 24h after surgery were evaluated as primary outcome. Drug-related side effects were also evaluated as a secondary outcome. Somnolence was evaluated using Ramsay Sedation Scale, while nausea and vomiting were assessed using numeric scores. The data were analyzed using SPSS.
  
  
  RESULTS
  Preemptive pregabalin in different concentrations provided better pain relief as compared with placebo. Post-hoc test indicated that there was a significant difference among four groups, indicating where the concentration was increased, the pain score decreased as an independent variable of time. The highest concentration of pregabalin (300mg) revealed higher sedation scores as compared with other groups.
  
  
  CONCLUSIONS
  Our data demonstrated preemptive administration of 75, 150, and 300mg pregabalin play an important role in reducing postoperative pain after laparoscopic hysterectomy. Comparison of different concentrations and side effects indicates oral administration of 150mg pregabalin is an effective and safe method for postoperative pain management after laparoscopic hysterectomy.
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: dr.zahra.asgari@gmail.com.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Asgari
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. Electronic address: s_rouholamin@med.mui.ac.ir.
authors.forename: Safoura
authors.initials: S
authors.lastname: Rouholamin
authors.affiliation: Department of Anesthesiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: m-nataj@farabi.tums.ac.ir.
authors.forename: Masoomeh
authors.initials: M
authors.lastname: Nataj
authors.affiliation: Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran. Electronic address: mahdi.sepidarkish@gmail.com.
authors.forename: Mahdi
authors.initials: M
authors.lastname: Sepidarkish
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: rayh_h@yahoo.com.
authors.forename: Reihaneh
authors.initials: R
authors.lastname: Hosseini
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran. Electronic address: dr.razavi351@gmail.com.
authors.forename: Maryam
authors.initials: M
authors.lastname: Razavi
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000700:Analgesics / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D004244:Dizziness / Q000139:chemically induced; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects*; D007492:Iran; D008875:Middle Aged; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D020250:Postoperative Nausea and Vomiting / Q000139:chemically induced; D000069583:Pregabalin / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D000700:Analgesics; D000069583:Pregabalin
keywords: Laparoscopic hysterectomy; Postoperative pain; Preemptive analgesia; Pregabalin