Comparative study of preoperative oral pregabalin alone,pregabalin with dexamethasone and pregabalin with Vitamin B complex for postoperative analgesic requirement in open inguinal hernia repair under subarachanoid block.

PROJECT SUMMARY: Prevention and treatment of postoperative pain continues to be a major concern in postoperative care and plays an important role in the early mobilization and well being of the surgical patient.Postoperative pain due to tissue injury and surgical trauma is associated with neuroendocrine stress responses, catecholamine,inflammatory mediator release, and central sensitization,which is considered to be one of the mechanisms responsible for the persistence of postoperative pain.Preventing central sensitization with multimodal analgesicinterventions could reduce the intensity or even eliminate acutepostoperative pain hyperalgesia and chronic pain after surgery.Role of pregabalinhas been established in literature  for postoperative pain other than neuropathic painwith good results.[3,4] On the other hand Dexamethasone is known to have some analgesic,antiemetic properties but its efficacy as an adjuvant analgesic for postoperative pain in cases under spinal anaesthesia  is not studied extensively. Recently few studies have shown the role of Vitamin B complex in Acute pain although there is limited literature supporting its adjuvant analgesic role for postoperative pain.However there is paucity of studies in comparison with pregabalin alone with dexamethasone and pregabalin with vitamin B complex for postoperative pain. This study is designed to compare their efficacy with respect to increase in duration of analgesia, reduction in total post- operative requirements of analgesics and study side effects and complications in Three groups.One twentysix  patients of either sex in ASA grade I and II were randomly allocated to one of the three groups of fortytwo each. The patients in Group I will be given single dose of oral capsulePregabalin 300mg with  IV Placebo in 100ml NS( over 15 minutes) one hour prior to administration of spinal anaesthesia in patient of Open Inguinal hernia repair.Group II will be administered oral capsule Pregabalin 300mg with IV Inj Dexamethasone 8 mg in 100ml NS( over 15 minutes) one hour prior to administration of spinal anaesthesia in patient of open inguinal hernia repair.Group III will be administered oral capsule Pregabalin 300 mg  with Inj VitaminB complex(Inj Thiamine 1gm, pyridoxine hydrocloride 1gm,Cyanocobalamine 100mcg,Dexpanthenol 15mg) in 100ml NS( over 15 minutes, close watch for hypersensitivity reaction for 5 minutes,if present stop infusion and noted )one hour prior to administration of spinal anaesthesia in patient of open inguinal hernia repair. The patients will be observed periopeatively for variations in haemodyanamic parameters, sedation scores and incidence of adverse effects among the groups.Postoperatively pain was assessed by Visual Analogue Scale immediate postoperatively and upto 24 hours thereafter. Time since spinal anaesthesia to first dose of analgesic and total dose of analgesic in first 24 hours will be recorded.