Comparison of the effect of preemptive pregabalin versus pethidine on postoperative pain after septorhinoplasty.

Background: Postoperative pain after septorhinoplasty can lead to significant patient discomfort and various complications. Opioids, while effective, are associated with adverse side effects. This study aimed to compare the analgesic efficacy of preoperative pregabalin with postoperative pethidine in managing pain following septorhinoplasty. Methods: This double-blind, randomized controlled clinical trial included 100 patients aged 19-45 years undergoing septorhinoplasty. Patients were randomly assigned to one of two groups: the pregabalin group (n = 50) received a 150 mg oral dose 1 h before surgery, and the pethidine group (n = 50) received 10-50 mg intravenous pethidine in the recovery room if pain occurred. Pain was assessed using the Visual Analogue Scale (VAS) at 30 min, 2 h, and 4 h post-operation. Data were analyzed using SPSS 22, with a significance level of p < 0.05. Results: The mean pain scores were significantly lower in the pregabalin group compared to the pethidine group at 2 and 4 h post-operation (p < 0.05). No significant difference was found in pain scores at 30 min post-operation. The pregabalin group also had a significantly higher baseline heart rate (p = 0.036), though this did not impact other hemodynamic parameters. The incidence of nausea was not statistically different between the two groups at any time point. Additional adverse events, including dizziness, somnolence, and visual disturbances, were systematically evaluated and found to be low in incidence with no significant differences between groups. Conclusions: Preoperative administration of a 150 mg dose of pregabalin is a simple, effective, and low-complication method for reducing postoperative pain after septorhinoplasty compared to the use of rescue pethidine. This approach can improve patient satisfaction. Further research is needed to investigate the effects of different doses of pregabalin and pethidine.