Effects of pregabalin on perioperative opioid-sparing effects on patients undergoing craniotomies for brain tumors. A Randomized, double-blinded, placebo controlled study.

• A craniotomy is a neurosurgical procedure done to get a wide cranial opening for doing surgical therapeutic maneuvers. Posi-craniotomy pain is a common entity. Pain can elicit a complex set of neural, and cardiac. and respiratory changes, leading to increased cerebral blood flow and intracranial pressure, cerebral edema, and even intracranial bleeding operative analgesics. Traditionally, opioids are being used in craniotomy cases for induction, intraoperative pain management, and post• operative pain management. Opioids are potent analgesics but their usage can interfere with neurological monitoring and are associated with serious side effects like PONV, constipation, pruritis, sedation, opioid-induced hyperalgesia (OIH), and life-threatening respiratory depression.  Pregabalin has been evaluated for postoperative analgesia in orthopedic and spine surgeries, laparoscopic hysterectomy, laparoscopic cholecystectomy, and thoracotomy, etc., Preemptive use of gabapentinoids is also known to effectively reduce opioid consumption There is a deficiency of trials investigating its effects in attenuating perioperative pain in intracranial surgeries. This study was designed to evaluate the opioid-sparing effect of preoperative pregabalin in patients undergoing craniotomy for brain tumors Studies of pregabalin in neurosurgical patients are scarce. There are only a few published randomized studies of pregabalin use for analgesia in patients undergoing craniotomy and these limited studies compare pre-emptive pregabalin and gabapentin and their opioid-sparing effects. However, these studies have some drawbacks like using sub-therapeutic doses of pregabalin, non-consideration of opioid side effects, and prolonged postoperative use of pregabalin, which we would like to correct in our study.