Is there any difference between oral preemptive pregabalin vs. placebo administration on response to EBUS-TBNA under sedation?

ALAGÖZ, ALİ; Sazak, Hilal; Aydemir, Semih; Ulus, Fatma; Yılmaz Demirci, Nilgün; Tunc, Mehtap

doi:10.3906/sag-2005-305

Is there any difference between oral preemptive pregabalin vs. placebo administration on response to EBUS-TBNA under sedation?

Semih AYDEMİR, (Sağlık Bilimleri Üniversitesi, Tıp Fakültesi, Atatürk Göğüs Hastalıkları ve Göğüs Cerrahisi Eğitim ve Araştırma Hastanesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, Ankara, Türkiye)

Ali ALAGÖZ, (Sağlık Bilimleri Üniversitesi, Tıp Fakültesi, Atatürk Göğüs Hastalıkları ve Göğüs Cerrahisi Eğitim ve Araştırma Hastanesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, Ankara, Türkiye)

Fatma ULUS, (Sağlık Bilimleri Üniversitesi, Tıp Fakültesi, Atatürk Göğüs Hastalıkları ve Göğüs Cerrahisi Eğitim ve Araştırma Hastanesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, Ankara, Türkiye)

Mehtap TUNÇ, (Sağlık Bilimleri Üniversitesi, Tıp Fakültesi, Atatürk Göğüs Hastalıkları ve Göğüs Cerrahisi Eğitim ve Araştırma Hastanesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, Ankara, Türkiye)

Hilal SAZAK, (Sağlık Bilimleri Üniversitesi, Tıp Fakültesi, Atatürk Göğüs Hastalıkları ve Göğüs Cerrahisi Eğitim ve Araştırma Hastanesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, Ankara, Türkiye)

Nilgun Yilmaz DEMİRCİ (Gazi Üniversitesi, Tıp Fakültesi, Göğüs Hastalıkları Anabilim Dalı, Ankara, Türkiye)

Turkish Journal of Medical Sciences

1 0

Yıl: 2021 Cilt: 51 Sayı: 1 Sayfa Aralığı: 195 - 203 Metin Dili: İngilizce DOI: 10.3906/sag-2005-305 İndeks Tarihi: 26-01-2022

Is there any difference between oral preemptive pregabalin vs. placebo administration on response to EBUS-TBNA under sedation?

Öz:

Background/aim: The aim of this study is to evaluate the effects of preemptive oral pregabalin on hemodynamic response, anxiety, sedation, and recovery in patients who underwent endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) under sedation with intravenous ketamine-propofol combination. Materials and methods: Sixty patients were included in this study, and patients were randomly divided into two equal groups to receive the placebo (Group 1) versus pregabalin 150 mg (Group 2) one hour prior to EBUS- TBNA procedure. Patients received 0.25 mg kg-1 ketamine and 0.25 mg kg-1 propofol mixture (ketofol) for sedation. Timing of the parameters was defined as follows; T0: in hospital ward before pregabalin or placebo administration, T1: premedication, T2: in operating room, T3: before the procedure, T4: initiation, T5: 3 min after induction, T6: 6 min after induction, T7: 9 min after induction, and T8: 12 min after induction. Hemodynamic parameters, severity of coughing, sedation and anxiety scores, and complications were recorded. The level of satisfaction of the bronchoscopist and the patients were evaluated at the end of the procedure. Results: The heart rate and mean arterial pressure were significantly higher in Group 1 (P = 0.008, P = 0.04). Total doses of anesthetics, recovery time, and desaturation rate were significantly higher in Group 1 (P = 0.014, P = 0.001, P = 0.045). In Group 2, SpO2level was significantly higher at various time periods (T1; P = 0.025, T4; P =0.043, T6; P = 0.001, T7; P = 0.003, T8; P < 0.001). The severity of coughing was found significantly lower in Group 2 (T4; P = 0.011, T5; P = 0.01, T6; P = 0.02, T7; P = 0.03, T8; P < 0.01). Anxiety scores were significantly lower in Group 2 (P < 0.001). Conclusion: Preemptive oral pregabalin, in addition to sedation with ketamine-propofol combination, was effective in providing limited hemodynamic response, restricted coughing reflex, and lower anxiety during EBUS-TBNA. Besides, with pregabalin usage, decreased anesthetics consumption, lower complication rate, and shorter recovery time might have contributed to safety of the procedure and comfort of the bronchoscopist.Key words: Pregabalin, endobronchial ultrasonography, sedation, ketamine, propofol, anxiety

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. Hylton DA, Turner S, Kidane B, Spicer J, Xie F et al. The Canada Lymph Node Score for prediction of malignancy in mediastinal lymph nodes during endobronchial ultrasound. The Journal of Thoracic and Cardiovascular Surgery 2020; 159 (6): 2499-2507. doi: 10.1016/j.jtcvs.2019.10.205
2. Dal T, Sazak H, Tunç M, Şahin Ş, Yılmaz A. A comparison of ketamine-midazolam and ketamine-propofol combinations used for sedation in the endobronchial ultrasound-guided transbronchial needle aspiration: a prospective, single-blind, randomized study. Journal of Thoracic Disease 2014; 6 (6): 742-751. doi: 10.3978/j.issn.2072-1439.2014.04.10
3. Sazak H, Tunç M, Alagöz A, Pehlivanoğlu P, Demirci NY et al. Assessment of perianesthesic data in subjects undergoing endobronchial ultrasound-guided transbronchial needle aspiration. Respiratory Care 2015; 60 (4): 567-576. doi: 10.4187/respcare.03547
4. Shimony N, Amit U, Minz B, Grossman R, Dany MA et al. Perioperative pregabalin for reducing pain, analgesic consumption, and anxiety and enhancing sleep quality in elective neurosurgical patients: a prospective, randomized, double-blind, and controlled clinical study. Journal of Neurosurgery 2016; 125 (6): 1513-1522. doi: 10.3171/2015.10.jns151516
5. Torres-González MI, Manzano-Moreno FJ, Vallecillo-Capilla MF, Olmedo-Gaya MV. Preoperative oral pregabalin for anxiety control: a systematic review. Clinical Oral Investigations 2020; 24 (7): 2219-2228. doi: 10.1007/s00784-020-03352-y
6. Dahl JB, Mathiesen O, Moiniche S. Protective premedication: an option with gabapentin and related drugs? A review of gabapentin and pregabalin in the treatment of post-operative pain. Acta Anaesthesiologica Scandinavica 2004; 48 (9): 1130- 1136. doi: 10.1111/j.1399-6576.2004.00484
7. Jain A, Sinha R, Pandey S, Sahu V. Comparative evaluation of dexmedetomidine and pregabalin as premedication agent to attenuate adverse hemodynamic and stress response in patients undergoing laparoscopic cholecystectomy. Anesthesia Essays Research 2019; 13 (4): 608-614. doi: 10.4103/aer.AER-115-19
8. Kim JC, Choi YS, Kim KN, Shim JK, Lee JY et al. Effective dose of peri-operative oral pregabalin as an adjunct to multimodal analgesic regimen in lumbar Spinal fusion surgery. Spine 2011; 36 (6): 428-433. doi:10.1097/BRS.0b013e3181d26708
9. Rastogi B, Gupta K, Gupta PK, Agarwal S, Jain M et al. Oral pregabalin premedication for attenuation of haemodynamic pressor response of airway instrumentation during general anaesthesia: A dose response study. Indian Journal of Anaesthesia 2012; 56 (1): 49-54. 10.4103/0019-5049.93344
10. Facco E, Stellini E, Bacci C, Manani G, Pavan C et al. Validation of visual analogue scale for anxiety (VAS-A) in preanesthesia evaluation. Minerva Anestesiologica 2013; 79 (12), 1389-1395. PMID: 23860442
11. Minogue SC, Ralph J, Lampa MJ. Laryngotracheal topicalization with lidocaine before intubation decreases the incidence of coughing on emergence from general anesthesia. Anesthesia Analgesia 2004; 99 (4):1253-1257. doi: 10.1213/01.ANE.0000132779.27085.52
12. Ghojazadeh M, Sanaie S, Paknezhad SP, Faghih SS, Soleimanpour H. Using ketamine and propofol for procedural sedation of adults in the emergency department: a systematic review and meta-analysis. Advanced Pharmaceutical Bullettin 2019; 9 (1): 5-11. doi:10.15171/apb.2019.002
13. Oh C, Kim Y, Eom H, Youn S. Lee S et al. Procedural sedation using a propofol-ketamine combination (ketofol) vs. propofol alone in the loop electrosurgical excision procedure (LEEP): a randomized controlled trial. Journal of Clinical Medicine 2019; 8 (7): 943. doi.org/10.3390/jcm8070943
14. Seifert H, Schmitt TH, Gultekin T, Caspary WF, Wehrmann T. Sedation with propofol plus midazolam versus propofol alone for interventional endoscopic procedures: a prospective, randomized study. Alimentary Pharmacology & Therapeutics 2000; 14 (9): 1207-1214. doi: 10.1046/j.1365-2036.2000.00787.x
15. Elaine VW, Gary A. A prospective evalution of ketafol (ketamine/ propofol combination) for procedural sedation and analgesia in the emergency department. Annals of Emergency Medicine 2007; 49 (1): 23-30. doi: 10.1016/j. annemergmed.2006.08.002
16. Doddaiah DB, Singh NR, Fatima N, Singh SS, Singh HK, et al. A comparative study of oral pregabalin and oral gabapentin in the attenuation of hemodynamic response to laryngoscopy and intubation. Journal of Medical Society 2017;31 (1):14-18. doi: 10.4103/0972-4958.198428
17. Gonano C, Latzke D, Sabeti-Aschraf M, Kettner SC, Chiari A et al. The anxioloytic effect of pregabalin in outpatients undergoing minor orthopaedic surgery. Journal of Psychopharmacology 2011;25 (2): 249-253. doi: 10.1177/0269881109106928
18. Polat SB, Kol IÖ, Avci O, Işbir AC, Kaygusuz K et al. Evaluation of preoperative anxiolytic and postoperative analgesic effects of pregabalin premedication. Türkiye Klinikleri Journal of Medical Science 2019; 39 (1): 9-18.doi:10.5336/medsci.2018-62181
19. Kye YC, Rhee JE, Kim K, Kim T, Jo YH et al. Clinical effects of adjunctive atropine during ketamine sedation in pediatric emergency patients. American Journal of Emergency Medicine 2012; 30 (9): 1981-1985. doi: 10.1016/j. ajem.2012.04.030
20. Guler G, Aksu R, Bicer C, Tosun Z, Boyaci A. Comparison of the effects of ketamine or lidocaine on fentanyl-induced cough in patients undergoing surgery: a prospective, double-blind, randomized, placebo-controlled study. Current Therapeutic Research, Clinical and Experimental 2010; 71 (5); 289-297. doi:10.1016/j.curtheres.2010.10.004
21. Vertigan AE, Kapela SL, Ryan NM, Birring SS, McElduff P et al. Pregabalin and speech pathology combination therapy for refractory chronic cough: a randomized controlled trial. Chest 2016; 149 (3): 639-648. doi: 10.1378/chest.15-1271
22. Kennedy MP, Shweihat Y, Sarkiss M, Eapen GA. Complete mediastinal and hilar lymph node sedation or general anesthesia? Chest 2008; 134 (6): 1350-1351. doi: 10.1378/ chest.08-1300
23. Casal RF, Lazarus DR, Kuhl K, Nogueras-González G, Perusich S et al. Randomized trial of endobronchial ultrasound–guided transbronchial needle aspiration under general anesthesia versus moderate sedation. American Journal of Respiratory and Critical Care Medicine 2015;191 (7):796-803. doi: 10.1164/ rccm.201409-1615OC
24. Daniel PS, Louis BI. Patient satisfaction during endobronchial ultrasound-guided transbronchial needle aspiration performed under conscious sedation. Respiratory Care 2010; 55 (6): 702- 706. PMID: 20507652
25. Tunç M, Çınar D, Şahin Ş, Sazak H , Köse SK. The effects of pre-emptive pregabalin on post-thoracotomy pain and epidural analgesia. Turkish Journal of Thoracic and Cardiovascular Surgery 2014; 22 (1): 129-137. doi: 10.5606/ tgkdc.dergisi.2014.8029
26. Kochhar A, Banday J, Ahmad Z, Monga S, Vajifdar H. Pregabalin in monitored anesthesia care for ear-nose-throat surgery. Anesthesia Essays and Researches 2017; 11 (2): 350- 353. doi:10.4103/0259-1162.194589
27. Asano F, Aoe M, Ohsaki Y, Okada Y, Sasada S et al. Complications associated with endobronchial ultrasoundguided transbronchial needle aspiration: a nationwide survey by the Japan Society for Respiratory Endoscopy. Respiratory Research 2013; 14 (1): 1-8. doi.org/10.1186/1465-9921-14-50
28. Dang D, Robinson PC, Winnicki S, Jersmann HPA. The safety of flexible fibre-optic bronchoscopy and proceduralistadministered sedation: a tertiary referral centre experience. Internal Medicine Journal 2012; 42 (3): 300-305.doi: 10.1111/j.1445-5994.2010.02261.x

APA	Aydemir S, ALAGÖZ A, Ulus F, Tunc M, Sazak H, Yılmaz Demirci N (2021). Is there any difference between oral preemptive pregabalin vs. placebo administration on response to EBUS-TBNA under sedation?. , 195 - 203. 10.3906/sag-2005-305
Chicago	Aydemir Semih,ALAGÖZ ALİ,Ulus Fatma,Tunc Mehtap,Sazak Hilal,Yılmaz Demirci Nilgün Is there any difference between oral preemptive pregabalin vs. placebo administration on response to EBUS-TBNA under sedation?. (2021): 195 - 203. 10.3906/sag-2005-305
MLA	Aydemir Semih,ALAGÖZ ALİ,Ulus Fatma,Tunc Mehtap,Sazak Hilal,Yılmaz Demirci Nilgün Is there any difference between oral preemptive pregabalin vs. placebo administration on response to EBUS-TBNA under sedation?. , 2021, ss.195 - 203. 10.3906/sag-2005-305
AMA	Aydemir S,ALAGÖZ A,Ulus F,Tunc M,Sazak H,Yılmaz Demirci N Is there any difference between oral preemptive pregabalin vs. placebo administration on response to EBUS-TBNA under sedation?. . 2021; 195 - 203. 10.3906/sag-2005-305
Vancouver	Aydemir S,ALAGÖZ A,Ulus F,Tunc M,Sazak H,Yılmaz Demirci N Is there any difference between oral preemptive pregabalin vs. placebo administration on response to EBUS-TBNA under sedation?. . 2021; 195 - 203. 10.3906/sag-2005-305
IEEE	Aydemir S,ALAGÖZ A,Ulus F,Tunc M,Sazak H,Yılmaz Demirci N "Is there any difference between oral preemptive pregabalin vs. placebo administration on response to EBUS-TBNA under sedation?." , ss.195 - 203, 2021. 10.3906/sag-2005-305
ISNAD	Aydemir, Semih vd. "Is there any difference between oral preemptive pregabalin vs. placebo administration on response to EBUS-TBNA under sedation?". (2021), 195-203. https://doi.org/10.3906/sag-2005-305

APA	Aydemir S, ALAGÖZ A, Ulus F, Tunc M, Sazak H, Yılmaz Demirci N (2021). Is there any difference between oral preemptive pregabalin vs. placebo administration on response to EBUS-TBNA under sedation?. Turkish Journal of Medical Sciences, 51(1), 195 - 203. 10.3906/sag-2005-305
Chicago	Aydemir Semih,ALAGÖZ ALİ,Ulus Fatma,Tunc Mehtap,Sazak Hilal,Yılmaz Demirci Nilgün Is there any difference between oral preemptive pregabalin vs. placebo administration on response to EBUS-TBNA under sedation?. Turkish Journal of Medical Sciences 51, no.1 (2021): 195 - 203. 10.3906/sag-2005-305
MLA	Aydemir Semih,ALAGÖZ ALİ,Ulus Fatma,Tunc Mehtap,Sazak Hilal,Yılmaz Demirci Nilgün Is there any difference between oral preemptive pregabalin vs. placebo administration on response to EBUS-TBNA under sedation?. Turkish Journal of Medical Sciences, vol.51, no.1, 2021, ss.195 - 203. 10.3906/sag-2005-305
AMA	Aydemir S,ALAGÖZ A,Ulus F,Tunc M,Sazak H,Yılmaz Demirci N Is there any difference between oral preemptive pregabalin vs. placebo administration on response to EBUS-TBNA under sedation?. Turkish Journal of Medical Sciences. 2021; 51(1): 195 - 203. 10.3906/sag-2005-305
Vancouver	Aydemir S,ALAGÖZ A,Ulus F,Tunc M,Sazak H,Yılmaz Demirci N Is there any difference between oral preemptive pregabalin vs. placebo administration on response to EBUS-TBNA under sedation?. Turkish Journal of Medical Sciences. 2021; 51(1): 195 - 203. 10.3906/sag-2005-305
IEEE	Aydemir S,ALAGÖZ A,Ulus F,Tunc M,Sazak H,Yılmaz Demirci N "Is there any difference between oral preemptive pregabalin vs. placebo administration on response to EBUS-TBNA under sedation?." Turkish Journal of Medical Sciences, 51, ss.195 - 203, 2021. 10.3906/sag-2005-305
ISNAD	Aydemir, Semih vd. "Is there any difference between oral preemptive pregabalin vs. placebo administration on response to EBUS-TBNA under sedation?". Turkish Journal of Medical Sciences 51/1 (2021), 195-203. https://doi.org/10.3906/sag-2005-305