Comparison between oral pregabalin and intravenous fentanyl on attenuation of blood glucose level as one modality of stress response to tracheal intubation and decreasing early post-operative pain

Introduction: Endotracheal tube remains the gold standard airway device for securing the 
airway during general anesthesia. However, Laryngoscopy and tracheal intubation are 
associated with haemodynamic stress responses due to sympathetic stimulation, which results 
in marked increase in heart rate, blood pressure, circulating catecholamines. Aim of the 
work: To evaluate the effect of oral pregabalin and intravenous fentanyl on attenuation 
of blood glucose level as one modality of the stress response to tracheal intubation 
and decrease early postoperative pain in elective upper abdominal surgeries. Patients and 
Methods: The study included seventy five (75) patients, aged 18-40 years old of both sex, 
ASA I or II, undergoing elective upper abdominal surgeries open cholecystectomy, renal 
stone ,pyeloplasty and nephrectomy under general anaesthesia with endotracheal intubation.
The patients were randomly divided into one of three groups, of 25 patients each (using 
computer generated randomization list): *Group (I): received 2µg/kg fentanyl iv route , 5 
minutes before surgery.*Group (II): received 150 mg pregabalin oral route two hours 
before surgery.*Group (III): Received 150 mg pregabalin oral 2 hours before surgery and 
2µg/kg fentanyl 5 minutes before surgery. Results: As regard MAP, HR, RR were significant 
lower in both groups [I] & [ Ш] when compared to group [II] and signifacntly lower in group 
[I] when compared to group [Ш]. Although there was Statistically significant reduction in 
values of MAP and HR in varying degrees when compared with their baseline values, there 
was no clinically symptomatic hypotension, bradycardia or respiratory depression required 
any treatment with naloxone or supplemental oxygen. Discussion: laryngoscopy alone or 
with tracheal intubation increases the arterial blood pressure and catecholamine levels, while 
intubation significantly increases heart rate This can also lead to increased risk of myocardial 
ischemia during tracheal intubation.We recommend: using fentanyl (2µg/kg) intravenous 5 
minutes and oral pregabalin (150 mg) 2 hours before operation for controlling of 
hemodynamic stress response and post operative analgesia also on attenuation of blood 
glucose level as one modality of stress response in patients undergoing upper abdominal 
surgeries under general anaesethsia