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- Sujeet Gautam, Anil Agarwal, Professor Anaesthesia, SGPGIMS, Lucknow, INDIA (24 October 2008)
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Pregabalin for Acute Pain Management: A Shift in Paradigm
- Aisha Siddqui, Santhanam Suresh, MD (14 October 2008)
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Sujeet Gautam, Senior Resident SGPGIMS, Lucknow, INDIA, Anil Agarwal, Professor Anaesthesia, SGPGIMS, Lucknow, INDIA
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We would like to show appreciation towards Siddiqui et al regarding their comments (1) on the use of preoperative single dose pregabalin for attenuation of acute postoperative pain (2). Pain is a multi-factorial phenomenon and is combinations of analgesics acting at different sites are advised; many improved synthetic variants of analgesic agents have been developed, but there is considerable opportunity for conceptual innovation. The present study was conducted with this basic aim. We would like to address some other concerns raised by Siddiqui et al. We did not use any regional anaesthesia techniques in the present study because all the patients included in the study received IV fentanyl via patient controlled analgesia device. Secondly, our study concluded 24 hrs postoperatively and therefore we did not evaluate our patients thereafter. Evaluation at a later stage for residual pain if any; certainly is a novel idea and further clinical trials can be designed in this direction. References: 1. Siddiqui A, Suresh S. Pregabalin for Acute Pain Management: A Shift in Paradigm. Br J Anaesth 2008; e letter 2. Agarwal A, Gautam S, Gupta D, Agarwal S, Singh PK, Singh U. Evaluation of a single preoperative dose of pregabalin for attenuation of postoperative pain after laparoscopic cholecystectomy. Br J Anaesth 2008; 101: 700-4 Conflict of Interest:None declared |
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Aisha Siddqui, Pediatric Anesthesiologist Children's Memorial Hospital, Northwestern University, Chicago, IL, Santhanam Suresh, MD
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We would like to commend the authors for this interesting and intriguing use of pregabalin for perioperative pain relief. The use of pregabalin in the management of acute pain control following surgery has been experimented for a significant period of time. Although pregabalin may prevent central sensitization and potentially reduce chronic pain, its use in the acute setting is gaining greater importance particularly when referring to multimodal analgesic techniques. Although this paper refers to the use of a higher dose of pregabalin (150 mg), there is no concerted effort to maximize the pain control using regional techniques in the operative and perioperative phase. This in addition may have provided a longer duration of pain relief. We are also curious to see if the authors contacted these patients after 2 weeks to see if there was any residual pain. If this is the case, then the addition of pregabalin to preoperative premedication may very well be the 'gold standard' for managing pain. Conflict of Interest:None declared |
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