Fast tracking possibility after outpatient anorectal surgery using "pregabalin" within multimodal analgesic regimen and monitored anaesthesia care technique

ABSTRACT

Pregabalin is a gabapentinoid compound, which has been alleged to possess anxiolytic, analgesic and anticonvulsant properties. Therefore, we designed a study to evaluate if the routine use of oral Pregabalin 150 mg within multimodal analgesic regimen [Dexamethasone-ketorolac-surgical field infiltration with local anesthetic mixture] would facilitate the early recovery process after anorectal surgery. Sixty adult outpatients undergoing anorectal surgery with standardized monitored anesthesia care technique were studied with one half of them receiving oral Pregabalin 150 mg. The other half of the Sixty patients is control group. All patients were received dexamethasone 4 mg IV and ketoraic 30 mg IV before induction. All patients were premedicated with midazolam 2 mg IV. A propofol infusion, 50 micro g kg[-1]. Min[-1] IV, was initiated and subsequently titrated to maintain an observer's assessment of alertness/sedation score 2 or 3 [with 5 awake/alert to 1=a sleep]. Fentanyl 25 micro g IV was administered 3-5 mm before infiltrating the surgical field with 30 ml local anesthetic mixture containing 15 ml of lidocaine 1% and 15 ml of bupivacaine 0.25% [with epinephrine 1200.000]. All patients were fast-tracked directly from the operating room to the step-down recovery area. Even thought the incidences of postoperative pain and postoperative nausea and vomiting were small in both treatment groups, the time to "home readiness" was significantly shorter in the Pregabalin group. Pregabalin 150 mg PO within multimodal analgesic regimen. Shortened the time to home readiness after outpatient anorectal surgery