A comparative analysis of oral pregabalin versus placebo in managing postoperative pain, nausea and vomiting in patients undergoing laparoscopic cholecystectomy

Laparoscopic cholecystectomy is one of the most common surgical procedures, however pain , nausea vomiting after this surgery is very frequent. Pain results to physiological and psychological response in patients which is detrimental to the postoperative outcome. Pathophysiology of pain have suggested that the central neural hyperexcitability that contributes to enhanced postoperative pain is preventable.  Different agents have been employed for preemptive analgesia such as nonsteroidal anti inflammatory drugs, NMDA antagonist and gamma amino butryic acid(GABA) analogues. Opioids are first alternative to treat moderate to severe pain but have adverse effects such as nausea , vomiting, respiratory depression and urinary retention. PONV is common in laparoscopic cholecystectomy. Nausea is a conscious recognition of subconscious excitation in an area of the medulla closely associated with or a part of vomiting centre, or it’s a sensation of discomfort in the upper abdomen and a sensation of unease with voluntary urge to vomit. Gabapentin has been used in managing postoperative pain and PONV. Compared to gabapentin, pregabalin pharmacokinetic is seen more favourable with better, faster, and more predictable absorption.