Pre-emptive gabapentin versus pregabalin for acute postoperative pain management in head and neck surgeries under general anaesthesia

Background: Gabapentin and pregabalin are antiepileptic drugs which are being used in the treatment of neuropathic pain as well as postoperative pain. However there is paucity of studies in comparison with each other in patients undergoing head and neck surgeries under general anaesthesia. Objectives: To evaluate and compare the efficacy of gabapentin and pregabalin with respect to increase in duration of analgesia, reduction in postoperative pain scores, total postoperative analgesic requirements and side effects in patients undergoing head and neck surgeries under general anaesthesia. Settings and design: A prospective, double-blinded, randomized controlled trial. Methods: 100 patients of either gender in ASA I and II were randomly allocated to one of the two groups of fifty each. Patients in group G received single dose of gabapentin 1200mg while in group P received pregabalin 300mg, 1 hour before induction of anaesthesia. Postoperatively, rescue analgesic was administered at visual analogue scale (VAS) >4. The VAS score, sedation score, time to rescue analgesia, total analgesic consumption and side effects were recorded. Results: ln the 24 hours of postoperative period, the mean VAS score of group P was significantly less than group G. Time for rescue analgesic requirement was more with group P than group G. Mean dose of tramadol administered in group P was significantly less when compared to group G. Sedation score was similar in both the groups. No significant difference was observed among the two groups regarding side effects. Conclusion: Pregabalin group had lower VAS score, prolonged timing of first rescue analgesic, and less analgesic consumption than the gabapentin group. Both the groups had similar sedation score with very negligible side effects.