The Effect of Pregabalin Levels on Pain and Substance P Level Post-Cesarean Section

Syafruddin Gaus; Muhammad Wirawan Harahap; Muhammad Ramli  Ahmad; Alamsyah Ambo Ala  Husain; Nur Surya Wirawan

doi:10.3889/oamjms.2023.10569

Authors

Syafruddin Gaus Department of Anesthesiology, Intensive Care, and Pain Management, Faculty of Medicine, Hasanuddin University, Wahidin Sudirohusodo Hospital, Makassar, Indonesia
Muhammad Wirawan Harahap Department of Anesthesiology, Intensive Care, and Pain Management, Faculty of Medicine, Hasanuddin University, Wahidin Sudirohusodo Hospital, Makassar, Indonesia https://orcid.org/0000-0003-3855-1337
Muhammad Ramli Ahmad Department of Anesthesiology, Intensive Care, and Pain Management, Faculty of Medicine, Hasanuddin University, Wahidin Sudirohusodo Hospital, Makassar, Indonesia
Alamsyah Ambo Ala Husain Department of Anesthesiology, Intensive Care, and Pain Management, Faculty of Medicine, Hasanuddin University, Bhayangkara Hospital, Makassar, Indonesia
Nur Surya Wirawan Department of Anesthesiology, Intensive Care, and Pain Management, Faculty of Medicine, Hasanuddin University, Wahidin Sudirohusodo Hospital, Makassar, Indonesia https://orcid.org/0000-0001-9378-733X

DOI:

https://doi.org/10.3889/oamjms.2023.10569

Keywords:

Pregabalin, Pain, Substance P, Post-operative, Cesarean Section Frequency

Abstract

BACKGROUND: Post-operative pain is a very important problem faced by post-operative patients. Antihyperalgesia is caused by the inhibition of the neurotransmitter glutamate and substance P (SP) by pregabalin. This study aimed to compare the effect of preventive administration of 50 mg oral pregabalin and 1 g paracetamol with 75 mg oral pregabalin and 1 g intravenous paracetamol on Numeric Rating Scale (NRS) scores and SP levels after cesarean section with spinal anesthesia.

AIM: The objective of the study was to compare the effect of preventive administration of 50 mg oral pregabalin and 1 g paracetamol with 75 mg oral pregabalin and 1 g intravenous paracetamol on NRS scores and SP levels after cesarean section with spinal anesthesia.

METHODS: This study used a double-blind randomized trial design. Samples were selected randomly and consecutively from the entire population that met the inclusion criteria. There were a total of 30 samples. SP levels were measured 2 h before cesarean section. The study drug was administered by mouth with a sip of water 1 h before the expected time of the surgical incision. SP levels were checked at the 4th h (SP 1) and 6th h (SP 2) postoperatively. The assessment of the degree of pain using the NRS was carried out at 2 h, 4 h, 6 h, 12 h, and 24 h postoperatively. This study used the Mann–Whitney U-test to compare both the levels of SP and NRS between the two groups.

RESULTS: The results of this study showed that there was a significant difference in the NRS scores between the 50 mg and 75 mg pregabalin groups (p < 0.05). In the 75 mg pregabalin group, the NRS scores were lower than in the 50 mg pregabalin group in patients undergoing CS surgery under spinal anesthesia. There was a significant difference in SP levels between the 50 mg and 75 mg pregabalin groups (p < 0.05). SP levels in the 50 mg pregabalin group increased at 4 h and 6 h postoperatively, while in the 75 mg pregabalin group, it tended to decrease at 4 h and 6 h postoperatively.

CONCLUSION: The quiescent and mobile NRS scores in the 75 mg pregabalin group were lower than the 50 mg pregabalin group with a combination of 1 g intravenous paracetamol after SC surgery. SP levels in the 75 mg pregabalin group decreased compared to the 50 mg pregabalin group with a 1 g intravenous paracetamol combination which experienced an increase after CS surgery. Pregabalin 75 mg is recommended for preventive use in CS surgery.

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Author Biography

Alamsyah Ambo Ala Husain, Department of Anesthesiology, Intensive Care, and Pain Management, Faculty of Medicine, Hasanuddin University, Bhayangkara Hospital, Makassar, Indonesia

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