Comparison of Different Doses of Pregabalin to Prevent Succinylcholine-Initiated Fasciculations and Myalgia in Patients Under General Anesthesia: A Randomised Controlled Study

TL;DR

This study compares low and high doses of pregabalin to reduce muscle twitching and pain caused by a common anesthetic drug, finding that higher doses are more effective.

Contribution

The study introduces a novel comparison of two pregabalin doses for mitigating succinylcholine-induced fasciculations and myalgia during anesthesia.

Findings

Higher doses of pregabalin (150 mg) were more effective than lower doses (75 mg) in reducing fasciculations and myalgia.

Pregabalin prolonged the time until patients needed pain medication compared to placebo.

Pregabalin also improved hemodynamic stability and reduced pressor responses more effectively at higher doses.

Abstract

Background

Succinylcholine (SCh) is the most commonly used muscle relaxant during endotracheal intubation, and it is known to cause fasciculations and postoperative myalgia. Pregabalin is structurally similar to the neurotransmitter gamma-aminobutyric acid (GABA), which is known to reduce SCh-induced fasciculations and myalgia.

Materials and methods

This study was conducted on patients who underwent surgery under general anesthesia. A total of 201 patients of both genders were assigned to one of the following groups: Group PL (pregabalin low dose) received cap pregabalin 75 mg, Group PH (pregabalin high dose) received cap pregabalin 150 mg, and Group P (placebo) received saccharine pill 10 mg, administered two hours prior to surgery.

Results

Both the incidence and severity of fasciculations and myalgia were reduced in patients who received pregabalin compared to the placebo group (PH>PL>P). It was observed that as the severity of fasciculations increased, myalgia also increased. The time of the first analgesic dose was longer in the pregabalin group (PH>PL>P). The attenuation of pressor response and hemodynamic stability was greater in the pregabalin group (Group PH>PL>P). Sedation levels were insignificant among groups. The incidence of adverse effects was also insignificant.

Conclusion

Preoperative prophylactic administration of pregabalin orally in Group PL and PH reduced the incidence and severity of fasciculations and myalgia. Group PH was found to be more effective than PL. Pressor response attenuation was found to be more effective in Group PH.

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