Evaluation of pre-emptive use of pregabalin for attenuation of post operative pain after laparoscopic abdominal surgeries.

Preemptive analgesia is an antinociceptive treatment that prevents establishment of altered processing of afferent input, which amplifies postoperative pain. Various pharmacological agents and techniques like local infiltration, epidural analgesia, nonsteroidal anti-inflammatory drugs, opioids, Gabapentin, pregabalin, alpha**-**2 agonist, cox-2 inhibitors are used to produce analgesia. Gabapentinoids are anti-convulsants with membrane stabilizing and anti-nociceptive effects. These drugs bind to the presynaptic a2–d subunit voltage-dependent calcium channel. The anti-nociceptive effect is believed to be related to the reduction of the Ca2+ influx at presynaptic terminals in hyperexcited neurons, which may lead to the reduction of the release of several excitatory neurotransmitters, including glutamate, norepinephrine, substance P, and calcitonin gene-related peptide. Thus, gabapentinoids appear to reduce the hyperexcitability of dorsal horn neurons that is induced by tissue damage.  Evidence supporting the postoperative analgesic efficacy of pregabalin is limited to randomized controlled trials in patients undergoing dental surgery, spinal fusion surgery, laparoscopic hysterectomy and day-case gynaecological laparoscopic surgery. Few of these trials has investigated the role of preoperative single-dose administration of pregabalin in attenuating postoperative pain after laparoscopic abdominal surgeries. The present study was therefore designed to evaluate the role of preoperative single dose of pregabalin for attenuating postoperative pain and analgesic consumption in patients undergoing laparoscopic abdominal surgeries.