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Pregabalin effects on hypotensive anesthesia during spine surgery

Background Elective lumbar spine surgeries are commonly performed under controlled hypotensive general anesthesia to ameliorate intraoperative blood loss and improve the surgical field. Purpose To demonstrate the effect of preoperative 150 mg oral pregabalin on facilitation of induced hypotension during spine surgery evaluated by the total intraoperative consumption of nitroglycerin required to maintain the targeted mean arterial blood pressure. Patients and methods This prospective, randomized, controlled, double-blinded study included two groups of adult patients, who had undergone elective spinal surgery: the pregabalin group (n=53): received oral pregabalin capsule 150 mg 1 h before general anesthesia and the control group (n=53): received oral placebo capsule. The intraoperative invasive mean arterial blood pressure was maintained at the targeted range of 55–65 mmHg by nitroglycerin infusion titration. The intraoperative hemodynamics, blood loss and postoperative sedation, pain scores, and morphine consumption were recorded. Results There was a statistically significant decrease in the consumption of both intraoperative nitroglycerin and postoperative morphine in the pregabalin group compared with the control group, but there was no concomitant decrease in intraoperative blood loss. Also, there was a statistically significant suppression of stress response to intubation in the pregabalin group. Conclusion Premedication with oral 150 mg pregabalin before elective spinal surgery facilitated induced hypotension. Furthermore, it attenuated the stress response to tracheal intubation and enhanced postoperative analgesia.