Comparison of different doses of injectable dexamethasone with and without pregabalin on pain, opioid need and hemodynamic parameters after surgery in elective laminectomy candidates

Abstract

Given that patients undergoing laminectomy often experience severe neuropathic pain for several weeks, or even months, pain management in these cases can be challenging. Therefore, adopting new approaches for pain management in these patients is crucial. The use of combination therapies for post-laminectomy pain management appears to significantly reduce the need for postoperative opioids. This reduction in pain is also associated with improved hemodynamic stability. Considering these factors, the present study aimed to compare the preventive effects of various doses of intravenous dexamethasone, with and without pregabalin, on pain, opioid requirement, and hemodynamic parameters following surgery in patients undergoing elective laminectomy. Materials and Methods: his randomized clinical trial was conducted as a double-blind study without a control group. Group 1: One hour before surgery, this group received 8 mg of intravenous dexamethasone, followed by 150 mg of oral pregabalin with 50 ml of water, and then they were transferred to the operating room. Group 2: One hour before surgery, this group received 8 mg of intravenous dexamethasone, followed by a placebo pill with 50 ml of water, and then they were transferred to the operating room. Group 3: One hour before surgery, this group received 4 mg of intravenous dexamethasone, followed by 150 mg of oral pregabalin with 50 ml of water, and then they were transferred to the operating room. Group 4: One hour before surgery, this group received 4 mg of intravenous dexamethasone, followed by a placebo pill with 50 ml of water, and then they were transferred to the operating room. Pain intensity, opioid requirement, and hemodynamic status were compared among the groups up to 24 hours post-surgery. Results: Patients who received higher doses of dexamethasone along with pregabalin experienced significantly less pain and required fewer opioids. Specifically, the group that received 8 mg of dexamethasone with pregabalin reported the lowest pain intensity and the least opioid consumption.