A PROSPECTIVE RANDOMIZED SINGLE-BLIND STUDY COMPARING ALPRAZOLAM VERSUS CLONIDINE AND PREGABALIN AS PREANAESTHETIC MEDICATION IN PATIENTS UNDERGOING ELECTIVE LOWER LIMB SURGERIES
DOI:
https://doi.org/10.22159/ajpcr.2023.v16i1.45576Keywords:
Alprazolam, Clonidine, Pregabalin, anxiety, s-STAI score, t-STAI score, CGI score, elective lower limb surgeryAbstract
Objective: The objective of the study was to study comparison of alprazolam versus clonidine and pregabalin as pre-anesthetic medication in patients undergoing elective lower limb surgeries.
Methods: The present study was undertaken to compare the effects of alprazolam 0.5 mg, clonidine 100 μg, and pregabalin 75 mg as premedicant drugs for the reduction of pre-operative anxiety. 90 patients of ASA Grades I and II, between 18 and 60 years, of either sex, undergoing elective lower limb surgery were divided into three groups of 30 patients each. Baseline anxiety level and level after 2 h of the drug were assessed. Side effects due to drugs were noted before going to OT (Post drug, i.e., 2 h after drug administration), after the completion of the surgery, and at 24 h.
Results: There is a significant post-drug reduction in s-STAI score, t-STAI score, and CGI score when compared to baseline values in all the Group’s A, C, and P. Side effects were mild and there were no serious adverse effects observed in all three groups. In Group A, 10% of patients complained of fatigue while in Group C, 13.3% of patients complained of dryness of mouth, and 10% of patients complained of headache 2 h post drug administration but in Group P, no side effect was noted.
Conclusion: Premedication with 0.5 mg alprazolam, 100 μg clonidine, and 75 mg pregabalin for control of pre-operative anxiety was comparable though pregabalin offered a significant advantage in terms of less side effects.
Downloads
References
Bansal T, Joon A. Preoperative anxiety-an important but neglected issue: A narrative review. Indian Anaesth Forum 2016;17:37-42. doi: 10.4103/0973-0311.195955
Nandan HN, Suresha BS, Monisha MN, Anwar CM, Ismail M, Vinesh U. Preanaesthetic: A review on current practice. World J Pharm Res 2018;7:988-1006.
George TT, Tripp J. Alprazolam. In: Treasure Island: Stat Pearls Publishing; 2022. Available from: https://www.ncbi.nlm.nih.gov/ books/NBK538165/[Last accessed on 2022 Feb 24].
Kulkarni P, Badaru KN, Joshi S, Srinivasa B, Hoysala H. Preoperative sedation using oral clonidine and oral gabapentin: A comparative study. J Evid Based Med Healthc 2014;1:1675-85.
Gajraj NM. Pregabalin: Its pharmacology and use in pain management. Anesth Analg 2007;105:1805-15. doi: 10.1213/01. ane.0000287643.13410.5e, PMID 18042886
Seok CB, Abd Hamid HS, Mutang JA, Ismail R. Psychometric properties of the state-trait anxiety inventory (Form Y) among Malaysian university students. Sustainability 2018;10:3311. doi: 10.3390/su10093311
Bugbee ME, Wellisch DK, Arnott IM, Maxwell JR, Kirsch DL, Sayre JW, et al. Breast core-needle biopsy: Clinical trial of relaxation technique versus medication versus no intervention for anxiety reduction. Radiology 2005;234:73-8. doi: 10.1148/radiol.2341030163, PMID 15564386
Kim D, Lee S, Pyeon T, Jeong S. Use of triazolam and alprazolam as premedication for general anesthesia. Korean J Anesthesiol 2015;68:346-51. doi: 10.4097/kjae.2015.68.4.346, PMID 26257846
Ozkan TA, Koprulu S, Karakose A, Dillioglugil O, Cevik I. Does using alprazolam during outpatient flexible cystoscopy decrease anxiety and pain? Arch Esp Urol 2017;70:800-5. PMID 29099383
Nasr DA, Abdellatif AA. Efficacy of preoperative melatonin versus pregabalin on perioperative anxiety and postoperative pain in gynecological surgeries. Egypt J Anaesth 2014;30:89-93. doi: 10.1016/j.egja.2013.10.001
Chaurasia SK, Kane DG, Chaudhari LS. A comparative study of clonidine versus a combination of diazepam and atropine for premedication in orthopaedic patients. J Postgrad Med 1999;45:74-8. PMID 10734339
Khanna J, Katoch M, Rajpur S. Comparative evaluation of melatonin, pregabalin and alprazolam as premedicants for perioperative anxiety and post operative pain for laparoscopic surgeries. JK Sci 2019;21: 64-71.
Hossain MS, Rashid MM, Islam SA, Babu MA, Saha D, Islam N, et al. Comparative study of oral clonidine versus gabapentin as premedication for anxiolysis, sedation and attenuation of pressor response to laryngoscopy and tracheal intubation. Anwer Khan Mod Med Coll J 2018;9:131-6. doi: 10.3329/akmmcj.v9i2.39209
De Witte JL, Alegret C, Sessler DI, Cammu G. Preoperative alprazolam reduces anxiety in ambulatory surgery patients: A comparison with oral midazolam. Anesth Analg 2002;95:1601-6. doi: 10.1097/00000539- 200212000-00024, PMID 12456424
Gupta K, Sharma D, Gupta PK. Oral premedication with pregabalin or clonidine for hemodynamic stability during laryngoscopy and laparoscopic cholecystectomy: A comparative evaluation. Saudi J Anaesth 2011;5:179-84. doi: 10.4103/1658-354X.82791, PMID 21804800
Ait-Daoud N, Hamby AS, Sharma S, Blevins D. A review of alprazolam use, misuse, and withdrawal. J Addict Med 2018;12:4-10. doi: 10.1097/ ADM.0000000000000350, PMID 28777203
Published
How to Cite
Issue
Section
Copyright (c) 2022 Mohd fazal Ahmed Makki, Dr. Seema Rani, Dr. Sanjeev Kumar, Dr. Pranav Bansal, Dr. Rahul Saini, Dr. Abhinav Goyal
This work is licensed under a Creative Commons Attribution 4.0 International License.
The publication is licensed under CC By and is open access. Copyright is with author and allowed to retain publishing rights without restrictions.
