In patients undergoing general anesthesia with Remifentanil for rhinoplasty, 300 mg of Pregabalin preoperatively is more efficient than intraoperative Mg sulphate infusion to prevent Remifentanil-stimulated hyperalgesia after rhinoplasty, according to a prospective, randomized, double-blinded placebo-controlled trial. Seyed Mohammad Reza Hadavi et al. sought to investigate Pregabalin and Magnesium sulphate for their ability to prevent postoperative Remifentanil-induced hyperalgesia.

A total of 105 patients who were scheduled to undergo rhinoplasty under general anesthesia were enrolled and divided into three groups at random. Prior to general anaesthesia, patients in group A received 300 mg of Pregabalin. During the perioperative period, physiologic saline infusion was given to them. For the duration of the perioperative phase, group B members received intravenous Mg sulphate 30 mg/kg and placebo capsules prior to anesthesia. Group C members got a placebo capsule prior to anaesthesia and regular intravenous saline during the procedure.

Assessment of postoperative nausea and vomiting (PONV), sedation score, and degree of pain was done. Compared to the Pregabalin group, the mean numerical rating scale (NRS) in postoperative period was greater in the Mg sulphate and placebo group up to 24 hours after surgery, as shown in Figure 1:

In comparison with the other groups, patients in the Pregabalin group reported a considerably lower mean overall morphine demand 24 hours after surgery. Pregabalin group participants exhibited lower PONV levels than Pregabalin and placebo group participants. Therefore, the use of preoperative 300 mg Pregabalin, as a part of a multimodal approach to pain management, could successfully prevent not only Remifentanil-triggered hyperalgesia but also PONV in individuals undergoing rhinoplasty.