An observational study to compare the effect of pregabalin with pregabalin and dexamethasone for post operative analgesia in orthopedic surgeries under spinal anesthesia

Background: Post-operative pain is a troublesome problem after orthopedic surgeries. Pregabalin acts as a synthetic analog of the neurotransmitter gamma-aminobutyric acid (GABA) with analgesic, anticonvulsant, and anxiolytic effects. Pregabalin is effective in controlling postoperative pain and in decreasing analgesic consumption. Glucocorticoids have strong anti-inflammatory effects and exhibit antiemetic and analgesic efficacy. Dexamethasone increases the efficacy of analgesia when given alone or in combination with other drugs. Material and methods: The aim was to determine the efficiency of pregabalin alone and the combination with dexamethasone to the orthopedic operations regarding postoperative pain control and analgesic consumption. It was an observational study in which participants were allocated in two groups of 30 each. In group P ? Tab Pregabalin: 300 mg and in group D ?Tab Pregabalin: 300 mg + Inj. Dexamethasone: 16 mg IV was given. Pain was assessed by Visual analogue scale at 0, 2, 4, 6, 12, 24 hours post-operatively. Any patient with the visual analogue scale more than 3 were given Inj. diclofenac 1.5 mg/kg IM. Time since spinal anesthesia to the first dose of analgesic and total dose of analgesic in first 24 hours was recorded. P<0.05 was considered statistically significant. Results: Rescue analgesia was not required only in 1 (3.3%) case in Group D. Those who required analgesia, maximum proportion of patients required two doses in Group P (n=17, 56.6 %) while in Group D the max proportion of patients required one dose (n=15; 50.0%). Statistically, the number of patients requiring more number of rescue analgesia was significantly higher in Group P as compared to Group D (p<0.001). Conclusion: Combined administration of pregabalin and dexamethasone conferred analgesic benefits superior to those of pregabalin alone, by reducing the requirement of rescue analgesia and side effects.