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Mahdy W, Saad K, Gad EF, Shabaan I, Hassan AEMM, Ezzat M, Afify NA. Efficacy and Safety of Single-Dose Pregabalin in Preoperative Pediatric Sedation. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2024; 16:S901-S904. [PMID: 38595464 PMCID: PMC11000948 DOI: 10.4103/jpbs.jpbs_1086_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 11/05/2023] [Accepted: 11/11/2023] [Indexed: 04/11/2024] Open
Abstract
Introduction This study aimed to investigate the anxiolytic and sedative effects of a single oral dose of 5 mg/kg pregabalin in pediatric patients undergoing elective surgery. It also assessed potential adverse effects and its impact on bispectral index (BIS) responses. Materials and Methods This prospective randomized clinical trial enrolled 60 pediatric patients undergoing minor elective surgery. Patients were randomly assigned to receive either oral pregabalin (5 mg/kg) or a placebo one hour before induction of anesthesia. Anxiety levels were assessed using the Visual Analog Scale for Anxiety (VAS-A), and sedation levels were evaluated using the Ramsay Sedation Scale (RSS). Results Pregabalin premedication significantly reduced preoperative anxiety, as indicated by lower VAS-A scores compared to the control group. Sedation levels, measured using the RSS, were significantly higher in the pregabalin group at various time points post-dose. During intubation, skin incision, and recovery, BIS responses were significantly lower in the pregabalin group. Conclusion The use of single-dose pregabalin preoperatively in children recorded a significant decrease in anxiety and achieved a state of sedation without an increase in adverse effects.
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Affiliation(s)
- Wafiya Mahdy
- Department of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Menoufia University, Menoufia, Egypt
| | - Khaled Saad
- Department of Pediatrics, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Eman F. Gad
- Department of Pediatrics, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Islam Shabaan
- Department of Psychiatry, Faculty of Medicine, Al Azhar University, Assiut, Egypt
| | | | - Mohamed Ezzat
- Department of Pediatrics, Faculty of Medicine, Al Azhar University, Cairo, Egypt
| | - Noha A. Afify
- Department of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Menoufia University, Menoufia, Egypt
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Mishra A, Srivastava VK, Prakash R, Mishra NK, Agarwal J, Kabi S. Perioperative Anxiolysis and Analgesic Effect after Premedication with Melatonin and Pregabalin in Total Hip Arthroplasty under Spinal Anaesthesia: A Prospective Comparative Trial. Adv Biomed Res 2023; 12:185. [PMID: 37694243 PMCID: PMC10492595 DOI: 10.4103/abr.abr_323_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 03/13/2023] [Accepted: 04/04/2023] [Indexed: 09/12/2023] Open
Abstract
Background Preoperative anxiety plays a critical role in post-operative pain response and other outcomes. Melatonin is a naturally secreted hormone which has anxiolytic, sedative, and analgesic properties. Pregabalin, analogue of gabapentin which has property of anxiolytic and analgesic effects. Materials and Methods Total 96 patients undergoing total hip arthroplasty, divided into 3 groups of 32 each and were given placebo (group I), melatonin 6 mg (group II), and pregabalin 150 mg (group III). Anxiety level, postoperative pain score, sedation level and duration as well as characteristics of spinal anaesthesia were assessed with other vital parameters. Results Group I showed an increment in the anxiety score from baseline whereas in group II and group III, there was a decline in pre-operative anxiety score from baseline at all the periods of observation and more significantly in group III. Visual analogue scale (VAS) score and total dose of rescue analgesia were highest in group I, but group II and group III were comparable to each other. However, the durations of spinal anaesthesia and motor blockade showed a statistically significant difference with maximum duration in group III followed by II and then I. The level of sedation among the three groups were comparable at all the periods of observation. Conclusions Pregabalin was found better for perioperative anxiolysis, post-operative analgesia and for prolongation of duration of spinal anaesthesia when compared to melatonin.
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Affiliation(s)
- Akash Mishra
- Department of Anaesthesiology, King George Medical University, Lucknow, Uttar Pradesh, India
| | - Vinod Kumar Srivastava
- Department of Anaesthesiology, King George Medical University, Lucknow, Uttar Pradesh, India
| | - Ravi Prakash
- Department of Anaesthesiology, King George Medical University, Lucknow, Uttar Pradesh, India
| | - Neel Kamal Mishra
- Department of Anaesthesiology, King George Medical University, Lucknow, Uttar Pradesh, India
| | - Jyotsna Agarwal
- Department of Anaesthesiology, King George Medical University, Lucknow, Uttar Pradesh, India
| | - Shruti Kabi
- Department of Anaesthesiology, King George Medical University, Lucknow, Uttar Pradesh, India
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Deligöz Ö. A Randomized, Prospective Evaluation the Effect of Oral Pregabalin in Forearm Surgery with Infraclavicular Nerve Block. ISTANBUL MEDICAL JOURNAL 2023. [DOI: 10.4274/imj.galenos.2023.37531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
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Kushwaha BB, Singh S, Srivastava VK, Prakash R, Verma R, Verma S. A Randomized, Double-Blind, Prospective Study to Evaluate the Effect of Oral Pregabalin in Upper Limb Surgeries Under Brachial Plexus Block. Cureus 2022; 14:e29117. [PMID: 36259032 PMCID: PMC9559696 DOI: 10.7759/cureus.29117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2022] [Indexed: 11/05/2022] Open
Abstract
Context The oral pregabalin administration preoperatively has been reported to reduce acute postoperative pain and prolong the duration of anesthesia produced by single-injection peripheral nerve blockade. Aim To study the effect of single dose pregabalin on duration of brachial plexus block Settings and design Prospective, randomised, double blind, comparative study Material and methods Patients were divided into two groups (groups A and B), with each group having 50 patients. In group A, the patient received a pregabalin capsule of 300 mg orally two hours before surgery with a sip of water. Group B received a placebo (vitamin B complex capsule) orally two hours before surgery. Brachial plexus block was performed, and data was collected. Statistical analysis Data analysis was done using SPSS version 21.0 statistical analysis software. Demographic data and clinical variables were compared using the student's t-test, chi-square test, and Mann-Whitney U test. Results The requirement of the first dose of analgesia was significantly earlier in group B as compared to group A (4:56±0:20 vs. 8:01±0:30 hours). Group B patients, as compared to group A patients, had significantly higher levels of pain after two hours of surgery (0.32±0.47 vs. 0.00±0.00) and at four hours of surgery (2.42±0.50 vs. 0.34±0.59). Conclusions Oral pregabalin prolongs analgesia from brachial plexus block without significant effect on the motor block. In addition, premedication with oral pregabalin increases the sensory block of brachial plexus block.
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Elrashidy A, Khattab AM, Elseify ZA, Oriby ME. Perioperative Anxiolytic and Analgesic Effects of Pregabalin in Vitreo-Retinal Surgery: A Randomized, Double-blind Study. Anesth Pain Med 2021; 11:e117414. [PMID: 34692442 PMCID: PMC8520673 DOI: 10.5812/aapm.117414] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 08/07/2021] [Accepted: 08/10/2021] [Indexed: 11/29/2022] Open
Abstract
Objectives This study was done to examine the effect of a single, one-time pregabalin dose on postoperative pain, anxiety, and analgesic consumption after vitrectomy performed under the peribulbar block and to assess the satisfaction of the patients as well as the surgeons. Methods This randomized, double-blinded, placebo-controlled trial was conducted at Magrabi Eye, ENT and Dental Center, Doha, Qatar on 58 adult patients aged 37 - 75 years, who met status I and II of the American Society of Anesthesiologists (ASA) and scheduled for elective vitrectomy, under the peribulbar block (PB). Of the total participants, 30 cases were randomized to receive pregabalin, while the remaining received placebo 90 minutes before surgery. Pain was assessed using a Verbal Analog Scale (VAS) score, and the levels of anxiety were gauged by verbal anxiety score. Results Patients who received pregabalin had a significantly higher sedation score (3 ± 0 vs. & 2 ± 0.65; P < 0.05), and a significantly less anxiety score (3 ± 1.3 vs. 5 ± 1.6; P < 0.001) compared to the control group. During needle insertion for PB, patients in the pregabalin group experienced less pain compared to the control group (32 ± 15 vs. 44 ± 15; P < 0.05). Pregabalin group showed a significantly higher cooperation rate and patient satisfaction scores (3.2 ± 0.7 and 3.8 ± 0.4, respectively), compared to the placebo group (2.8 ± 0.7 and 3.4 ± 0.5, respectively). The placebo group required intraoperative midazolam more in comparison to the pregabalin group (19 vs. 5; P < 0.001). Moreover, the need for postoperative analgesia was more in the placebo group two hours postoperatively. Conclusions Pregabalin is a potent premedication in controlling post-surgical pain and anxiety in patients undergoing vitrectomy under the PB.
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Affiliation(s)
- Ayman Elrashidy
- Tanta University, Tanta, Egypt
- Magrabi Eye, Ear and Dental Center, Doha, Qatar
| | | | | | - Mohamed E Oriby
- Department of Anesthesia and Surgical Intensive Care, Tanta University, Tanta, Egypt
- Anesthesia Department, Magrabi Center, Doha, Qatar
- Corresponding Author: Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Tanta University, Department of Anesthesia and Surgical Intensive Care, Tanta University, 23293, Tanta, Egypt. Tel: +974-33059056,
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Kavak Akelma F, Baran Akkuş I, Altinsoy S, Özkan D, Ergil J. The effects of pregabalin and adductor canal block on postoperative pain in arthroscopic anterior cruciate ligament reconstruction. Turk J Med Sci 2020; 50:195-204. [PMID: 31887853 PMCID: PMC7080358 DOI: 10.3906/sag-1906-66] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 12/29/2019] [Indexed: 01/09/2023] Open
Abstract
Background/aim To determine the effectiveness of pregabalin and adductor canal block on opioid consumption, postoperative pain, and fast-tracking. Materials and methods A total of 51 American Society of Anaesthesiologists (ASA) classification I–II patients aged 18–70 years who were scheduled to undergo elective anterior cruciate ligament reconstruction were included in the study. Patients were randomized into groups P, A, and C. Patients in group P (n = 16), received 150 mg of preoperative oral pregabalin, patients in group A (n = 17) received postoperative adductor canal blockade, and patients in group C (n = 18) received neither adductor canal block nor pregabalin. Surgeries were performed under spinal anaesthesia with hyperbaric bupivacaine following monitorization. Demographic data along with block features, hemodynamic data, mean opioid consumption, numerical rating scale score, White’s fast-track score, and postoperative adverse effects were recorded. Results Fifty-seven patients were enrolled in the study, and 6 patients were excluded from the study; the data of 51 patients were included in the final analyses. Demographic characteristics and hemodynamic data were similar between the 3groups. Postoperative opioid consumption was significantly lower in groups A and P compared with group C (group P = 178.75 mg, group C = 318.61 mg, group A = 236.47 mg; P < 0.05). The regression of sensory block was significantly slower in group P (P < 0.05). The first analgesic requirement was earlier in group C than in groups P and A (P < 0.05). Patients in group P had higher fast-track scores at 8 h and 12 h compared with group C (P < 0.05); however, group A fast-track scores were similar to those of the other 2groups (P > 0.05). The rate of postoperative adverse effects was similar between the groups (P > 0.05). Conclusion Preoperative pregabalin (150 mg) reduced postoperative opioid consumption as much as adductor canal block in patients undergoing anterior cruciate ligament reconstruction. The first analgesic requirement was earlier in group C than in groups P and A. In addition, pregabalin can prolong the duration of spinal sensory block and shorten the time required to achieve high fast-tracking scores. We recommend the use of both methods as a part of multimodal analgesia.
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Affiliation(s)
- Fatma Kavak Akelma
- University of Health Sciences, Anaesthesiology and Reanimation Clinic, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Ilkay Baran Akkuş
- University of Health Sciences, Anaesthesiology and Reanimation Clinic, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Savaş Altinsoy
- University of Health Sciences, Anaesthesiology and Reanimation Clinic, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Derya Özkan
- University of Health Sciences, Anaesthesiology and Reanimation Clinic, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Jülide Ergil
- University of Health Sciences, Anaesthesiology and Reanimation Clinic, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
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Omara AF, Ahmed SA, Abusabaa MM. The Effect Of The Use Of Pre-Emptive Oral Pregabalin On The Postoperative Spinal Analgesia In Patients Presented For Orthopedic Surgeries: Randomized Controlled Trial. J Pain Res 2019; 12:2807-2814. [PMID: 31686901 PMCID: PMC6777433 DOI: 10.2147/jpr.s216184] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 09/17/2019] [Indexed: 11/23/2022] Open
Abstract
Background Preoperative oral pregabalin could improve postoperative analgesia and prevent chronic pain development. The aim of this study is to evaluate the effect of oral pregabalin on the duration and quality of postoperative analgesia in spinal anesthesia. Methods Sixty adult patients presented for internal fixation of femoral fracture under spinal anesthesia were included in the study. They were randomly distributed to a placebo group and a pregabalin group receiving 150 mg pregabalin capsules 1 hr before surgery. The onset, duration, and regression of sensory and motor block were recorded. Rescue analgesia consumption, postoperative pain score, and quality of sleep were also assessed. Results Oral pregabalin significantly prolonged the time to two-segment regression of sensory block, reaching 86.67±17.88 mins, the time required to regression of spinal block to L2, reaching 155.33± 34.71 mins, and the duration of motor block, reaching 138 ± 23.5 mins, with no effect on the onset of sensory or motor block (P = 0.60 and 0.62). It significantly decreased the VAS score 4 hrs, 6 hrs, and 12 hrs postoperatively, prolonged the duration of postoperative analgesia, reaching 392.00±47.23 mins, and decreased morphine consumption to 7.67±3.65 mg. It also improved the quality of sleep in the first night after surgery. Conclusion Preemptive oral pregabalin prolonged the time to the first request for postoperative analgesics and improved sleep in the first night after surgery.
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Affiliation(s)
- Amany F Omara
- Department of Anesthesiology and Surgical Intensive Care, Faculty of Medicine, Tanta University, Tanta 31527, Egypt
| | - Sameh A Ahmed
- Department of Anesthesiology and Surgical Intensive Care, Faculty of Medicine, Tanta University, Tanta 31527, Egypt
| | - Motaz Ma Abusabaa
- Department of Anesthesiology and Surgical Intensive Care, Faculty of Medicine, Tanta University, Tanta 31527, Egypt
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Hu J, Huang D, Li M, Wu C, Zhang J. Effects of a single dose of preoperative pregabalin and gabapentin for acute postoperative pain: a network meta-analysis of randomized controlled trials. J Pain Res 2018; 11:2633-2643. [PMID: 30519075 PMCID: PMC6233947 DOI: 10.2147/jpr.s170810] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Background Pregabalin (PGB) and gabapentin (GBP) are current and emerging drugs in the field of pre-emptive preoperative analgesia. However, the role of PGB or GBP in acute postoperative pain management still remains elusive. Materials and methods We conducted a comprehensive literature search of articles published by December 3, 2017. A total of 79 randomized controlled trials with 6,201 patients receiving single-dose premedication were included. Through a network meta-analysis (NMA), we validated the analgesic effect and incidence of adverse events by using various doses of PGB or GBP administration. Results NMA results suggested that the analgesic effect may be dose related. For 24-hour opioid consumption, a consistent decrease was found with the increase in the dose of PGB or GBP. For 24-hour pain score at rest, a high dose (≥150 mg) of PGB was more effective in decreasing pain score than a dose of 75 mg, and a high dose (≥900 mg) of GBP reduced pain intensity than doses of 300 or 600 mg. Moreover, the incidence of adverse reactions varied with varying doses of PGB or GBP. Conclusion A dose-response relationship was detected in opioid consumption and postoperative pain for a single-dose preoperative administration of PGB and GBP. Making reasonable choice of drugs and dosage may prevent the occurrence of adverse reactions.
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Affiliation(s)
- Jiaqi Hu
- Department of Anesthesiology, Zhejiang Chinese Medical University, Hangzhou, China.,Department of Anesthesiology, First Affiliated Hospital, Zhejiang Chinese Medical University, Hangzhou, China,
| | - Dongdong Huang
- Department of Pathology, Key Laboratory of Disease Proteomics of Zhejiang Province, School of Medicine, Zhejiang University, Hangzhou, China
| | - Minpu Li
- Department of Anesthesiology, Zhejiang Chinese Medical University, Hangzhou, China.,Department of Anesthesiology, First Affiliated Hospital, Zhejiang Chinese Medical University, Hangzhou, China,
| | - Chao Wu
- Department of Anesthesiology, Zhejiang Chinese Medical University, Hangzhou, China.,Department of Anesthesiology, First Affiliated Hospital, Zhejiang Chinese Medical University, Hangzhou, China,
| | - Juan Zhang
- Department of Anesthesiology, First Affiliated Hospital, Zhejiang Chinese Medical University, Hangzhou, China,
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Lee C, Lee J, Lee G, Lee H, Koh E, Hwang J. Pregabalin and Dexmedetomidine Combined for Pain After Total Knee Arthroplasty or Total Hip Arthroplasty Performed Under Spinal Anesthesia. Orthopedics 2018; 41:365-370. [PMID: 30371925 DOI: 10.3928/01477447-20181023-04] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 10/16/2018] [Indexed: 02/03/2023]
Abstract
Pregabalin and dexmedetomidine have been introduced to manage postoperative pain. This study evaluated the effect of the 2 drugs combined on pain in patients undergoing total knee or hip arthroplasty. A total of 124 patients undergoing total knee or hip arthroplasty under spinal anesthesia were randomly assigned to either group C (n=31, placebo), group P (n=33, pregabalin), group PD (n=29, pregabalin and dexmedetomidine), or group D (n=31, dexmedetomidine). One hour before spinal anesthesia, patients received 150 mg of pregabalin or placebo orally, and a bolus dose of 0.5 µg/ kg of intravenous dexmedetomidine was given over 10 minutes before induction of spinal anesthesia. This was followed by a continuous infusion of 0.5 µg/kg/h or the same calculated volume of normal saline until completion of the surgery. Clinically relevant pain for 24 hours postoperatively, including time to first analgesic request, visual analog scale score, ketorolac dose, and volume of patient-controlled analgesia consumed, was recorded. Group C had significantly longer time to first analgesic request, higher visual analog scale scores at rest and on movement, higher ketorolac dose, and higher volume of patient-controlled analgesia for the first 24 hours postoperatively compared with the other groups. Although group PD and group D had less clinically relevant pain than group P, group PD and group D were not significantly different. Dexmedetomidine was more effective than pregabalin for clinically relevant pain. Pregabalin and dexmedetomidine combined had no synergic effect compared with dexmedetomidine alone. [Orthopedics. 2018; 41(6):365-370.].
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MESH Headings
- Aged
- Analgesia, Patient-Controlled
- Analgesics, Non-Narcotic/therapeutic use
- Anesthesia, Spinal
- Anti-Inflammatory Agents, Non-Steroidal/therapeutic use
- Arthroplasty, Replacement, Hip/adverse effects
- Arthroplasty, Replacement, Knee/adverse effects
- Dexmedetomidine/therapeutic use
- Double-Blind Method
- Drug Therapy, Combination
- Female
- Humans
- Ketorolac/therapeutic use
- Male
- Middle Aged
- Pain Measurement
- Pain, Postoperative/drug therapy
- Pregabalin/therapeutic use
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Effects of pregabalin on postoperative pain after hysterectomy under spinal anesthesia with intrathecal morphine: a randomized controlled trial. J Anesth 2017; 31:861-868. [DOI: 10.1007/s00540-017-2406-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 09/05/2017] [Indexed: 10/18/2022]
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Dwivedi D, Gogna R, Tandon U, Sarin K, Bhatnagar V. Role of oral gabapentin as preemptive adjuvant with spinal anesthesia for postoperative pain in patients undergoing surgeries under spinal anesthesia. INDIAN JOURNAL OF PAIN 2017. [DOI: 10.4103/ijpn.ijpn_36_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Erratum: Preoperative pregabalin prolongs duration of spinal anesthesia and reduces early postoperative pain: A double-blind, randomized clinical CONSORT study: Erratum. Medicine (Baltimore) 2016; 95:e68e2. [PMID: 31265649 PMCID: PMC5059101 DOI: 10.1097/01.md.0000503454.98968.e2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
[This corrects the article DOI: 10.1097/MD.0000000000004828.].
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