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All Journal Jurnal Anestesi dan Terapi Intensif Udayana Jurnal Anestesiologi dan Terapi Intensif
I Putu Pramana Suarjaya
Udayana University
Health Professions Medicine & Pharmacology Physics

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Efficacy of Pregabalin Versus Gabapentin as Preemptive Analgesia in Patients Undergoing Modified Radical Mastectomy: a Randomized Controlled Trial Yolanda Jenny Yolanda Jenny; Made Septyana Parama Adi; I Putu Kurniyanta; I Putu Pramana Suarjaya
Jurnal Anestesiologi dan Terapi Intensif Vol. 2 No. 2 (2026): JATI AUGUST
Publisher : Udayana University and Indonesian Society of Anesthesiologists (PERDATIN)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/7btvrm40

Abstract

Introduction: Postoperative pain after modified radical mastectomy (MRM) increases morbidity, opioid use, and recovery time. Gabapentinoids may reduce central sensitization when administered before surgical injury. This study compared pregabalin and gabapentin as preemptive analgesics in patients undergoing MRM. Patients and Methods: This double-blind randomized controlled trial was conducted at Ngoerah Hospital, Denpasar. Forty-two patients scheduled for elective MRM were allocated to oral pregabalin 150 mg (n = 21) or oral gabapentin 900 mg (n = 21), administered two hours before surgery. The primary outcome was Visual Analogue Scale (VAS) pain score at 12, 24, and 48 hours postoperatively. Secondary outcomes were time to first rescue analgesia and cumulative opioid consumption during the first 24 postoperative hours. Between-group comparisons used the independent t-test or Mann-Whitney U test, as appropriate. Results: Pregabalin produced lower VAS scores than gabapentin at 12 hours (2.18 +/- 0.65 vs 2.65 +/- 0.74; p = 0.034), 24 hours (2.27 +/- 0.66 vs 2.71 +/- 0.63; p = 0.030), and 48 hours (1.90 +/- 0.65 vs 2.36 +/- 0.71; p = 0.033). Time to first rescue analgesia was longer with pregabalin (232.69 +/- 19.88 vs 219.88 +/- 17.81 minutes; p = 0.034), and 24-hour opioid consumption was lower (240 [145] vs 360 [155] micrograms fentanyl equivalent; p = 0.034). No adverse hemodynamic. Conclusion: Preoperative oral pregabalin 150 mg provided statistically superior analgesia and reduced opioid consumption compared with gabapentin 900 mg after MRM. However, the absolute differences in pain scores and rescueanalgesia time were modest; therefore, safety monitoring and larger studies are warranted
Anesthesia Management in Aneurysm Clipping Surgery with Chilaiditi Sign : a Case Report Wisnu Wardhana; I Putu Pramana Suarjaya
Jurnal Anestesiologi dan Terapi Intensif Vol. 2 No. 2 (2026): JATI AUGUST
Publisher : Udayana University and Indonesian Society of Anesthesiologists (PERDATIN)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/x59n1t02

Abstract

Chilaiditi sign is the asymptomatic interposition of the colon between the liver and diaphragm; when accompanied by gastrointestinal symptoms, it is termed Chilaiditi syndrome. Its coexistence with aneurysmal subarachnoid haemorrhage creates competing anaesthetic priorities, including aspiration prevention, lung protection, and control of cerebral haemodynamics. We report a 79-year-old woman who presented with sudden severe headache and transient loss of consciousness. Imaging demonstrated subarachnoid haemorrhage from a ruptured left posterior communicating artery aneurysm, together with incidental colonic interposition beneath an elevated right hemidiaphragm, bilateral pleural effusions, and partial right-lower-lobe collapse. After 10 hours of fasting and pharmacological aspiration-risk mitigation, general anaesthesia was induced with thiopental, remifentanil, and rocuronium using a modified rapid-sequence approach that included preoxygenation, cricoid pressure, gentle mask ventilation, and video laryngoscopy. Pressure-controlled ventilation and close haemodynamic control were maintained throughout aneurysm clipping. No intraoperative rupture, aspiration, haemodynamic instability, or respiratory deterioration occurred. The patient was extubated 36 hours after surgery and discharged on postoperative day 8 with a modified Rankin Scale score of 1. This case highlights the need to individualise induction and ventilation when Chilaiditi sign coexists with urgent intracranial surgery. The uneventful outcome of a single case should not be interpreted as evidence that modified induction is generally safer than classical rapid-sequence induction.
Efficacy of Pregabalin Versus Gabapentin as Preemptive Analgesia in Patients Undergoing Modified Radical Mastectomy: a Randomized Controlled Trial Yolanda Jenny Yolanda Jenny; Made Septyana Parama Adi; I Putu Kurniyanta; I Putu Pramana Suarjaya
Jurnal Anestesiologi dan Terapi Intensif Vol. 2 No. 2 (2026): JATI AUGUST
Publisher : Udayana University and Indonesian Society of Anesthesiologists (PERDATIN)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/7btvrm40

Abstract

Introduction: Postoperative pain after modified radical mastectomy (MRM) increases morbidity, opioid use, and recovery time. Gabapentinoids may reduce central sensitization when administered before surgical injury. This study compared pregabalin and gabapentin as preemptive analgesics in patients undergoing MRM. Patients and Methods: This double-blind randomized controlled trial was conducted at Ngoerah Hospital, Denpasar. Forty-two patients scheduled for elective MRM were allocated to oral pregabalin 150 mg (n = 21) or oral gabapentin 900 mg (n = 21), administered two hours before surgery. The primary outcome was Visual Analogue Scale (VAS) pain score at 12, 24, and 48 hours postoperatively. Secondary outcomes were time to first rescue analgesia and cumulative opioid consumption during the first 24 postoperative hours. Between-group comparisons used the independent t-test or Mann-Whitney U test, as appropriate. Results: Pregabalin produced lower VAS scores than gabapentin at 12 hours (2.18 +/- 0.65 vs 2.65 +/- 0.74; p = 0.034), 24 hours (2.27 +/- 0.66 vs 2.71 +/- 0.63; p = 0.030), and 48 hours (1.90 +/- 0.65 vs 2.36 +/- 0.71; p = 0.033). Time to first rescue analgesia was longer with pregabalin (232.69 +/- 19.88 vs 219.88 +/- 17.81 minutes; p = 0.034), and 24-hour opioid consumption was lower (240 [145] vs 360 [155] micrograms fentanyl equivalent; p = 0.034). No adverse hemodynamic. Conclusion: Preoperative oral pregabalin 150 mg provided statistically superior analgesia and reduced opioid consumption compared with gabapentin 900 mg after MRM. However, the absolute differences in pain scores and rescueanalgesia time were modest; therefore, safety monitoring and larger studies are warranted
Anesthesia Management in Aneurysm Clipping Surgery with Chilaiditi Sign : a Case Report Wisnu Wardhana; I Putu Pramana Suarjaya
Jurnal Anestesiologi dan Terapi Intensif Vol. 2 No. 2 (2026): JATI AUGUST
Publisher : Udayana University and Indonesian Society of Anesthesiologists (PERDATIN)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/x59n1t02

Abstract

Chilaiditi sign is the asymptomatic interposition of the colon between the liver and diaphragm; when accompanied by gastrointestinal symptoms, it is termed Chilaiditi syndrome. Its coexistence with aneurysmal subarachnoid haemorrhage creates competing anaesthetic priorities, including aspiration prevention, lung protection, and control of cerebral haemodynamics. We report a 79-year-old woman who presented with sudden severe headache and transient loss of consciousness. Imaging demonstrated subarachnoid haemorrhage from a ruptured left posterior communicating artery aneurysm, together with incidental colonic interposition beneath an elevated right hemidiaphragm, bilateral pleural effusions, and partial right-lower-lobe collapse. After 10 hours of fasting and pharmacological aspiration-risk mitigation, general anaesthesia was induced with thiopental, remifentanil, and rocuronium using a modified rapid-sequence approach that included preoxygenation, cricoid pressure, gentle mask ventilation, and video laryngoscopy. Pressure-controlled ventilation and close haemodynamic control were maintained throughout aneurysm clipping. No intraoperative rupture, aspiration, haemodynamic instability, or respiratory deterioration occurred. The patient was extubated 36 hours after surgery and discharged on postoperative day 8 with a modified Rankin Scale score of 1. This case highlights the need to individualise induction and ventilation when Chilaiditi sign coexists with urgent intracranial surgery. The uneventful outcome of a single case should not be interpreted as evidence that modified induction is generally safer than classical rapid-sequence induction.
Co-Authors I Putu Kurniyanta Made Septyana Parama Adi Wisnu Wardhana Yolanda Jenny Yolanda Jenny