Does Simple Oral Route of Administration Affect Acute Post Operative Pain?(Oral Pregabalin Versus Oral Morphine Sulphate) for Acute Post Operative Pain following Cancer Surgeries

Background and Objectives: Major cancer surgeries cause severe pain that may lead to serious risks. Preemptive analgesia with oral pregabalin and oral morphine may be used as a non invasive and simple route of administration to decrease this pain and decrease postoperative analgesic consumption. The aim of the study was to assess the analgesic efficacy of oral pregabalin versus oral morphine tablet as simple route of administration, in patients undergoing elective major cancer surgery.

Materials and Methods: This randomized, blinded, study was approved by local ethics committee of South Egypt Cancer Institute, Assiut University, Assiut – Egypt and include Sixty patients (ASA II, III) who underwent elective major cancer surgery were divided into two groups of 30 patients each. Patients of (Group I) received oral pregabalin 300 mg two hours preoperative, and patients of (group II) received oral morphine sulphate 30 mg two hours preoperative, After induction of GA, heart rate and mean arterial pressure were recorded intraoperatively , and postoperative NRS, heart rate , mean blood pressure, side effects and total analgesic consumption were also recorded.

Results: Pain scores by NRS, were comparable in both groups but postoperative total analgesic consumption there was reduction in the total amount of postoperative morphine consumption in group I (7.34±4.39) in comparison by group II (13.74±4.73) with (p<0.044). Also there was a significant optimization in intra-operative mean arterial pressure (MAP); and heart rate in group I in comparison to group II. The incidence of postoperative side effects such as nausea, sedation and vomiting were comparable in both groups.

Conclusion: We concluded that oral route of administration is effective and both oral drugs are efficient in acute pain control and pre-operative use of oral pregabaline showed that; better intra and postoperative haemodynamic profile with better pain relief total and associated with less postoperative analgesic consumption than oral morphine after major cancer surgery.

Keywords: Major cancer surgery, acute post operative pain, morphine sulphate tablets (MST), pregabaline- NRS.