在腹腔镜胆囊切除术中，预防性使用加巴喷丁可显著降低术后疼痛及急救镇痛药物的需求量。

Preemptive use of gabapentin significantly decreases postoperative pain and rescue analgesic requirements in laparoscopic cholecystectomy.

作者信息

Pandey Chandra Kant, Priye Shio, Singh Surendra, Singh Uttam, Singh Ram Badan, Singh Prabhat Kumar

机构信息

Department of Anaesthesiology and Biostatistics, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.

出版信息

Can J Anaesth. 2004 Apr;51(4):358-63. doi: 10.1007/BF03018240.

DOI:10.1007/BF03018240

PMID:15064265

Abstract

PURPOSE

To evaluate the comparative preemptive effects of gabapentin and tramadol on postoperative pain and fentanyl requirement in laparoscopic cholecystectomy.

METHODS

Four hundred fifty-nine ASA I and II patients were randomly assigned to receive 300 mg gabapentin, 100 mg tramadol or placebo in a double-blind manner two hours before laparoscopic cholecystectomy under general anesthesia. Postoperatively, patients' pain scores were recorded on a visual analogue scale every two hours for the initial 12 hr and thereafter every three hours for the next 12 hr. Patients received fentanyl 2 micro g*kg(-1) intravenously on demand. The total fentanyl consumption for each patient was recorded.

RESULTS

Patients in the gabapentin group had significantly lower pain scores at all time intervals (2.65 +/- 3.00, 1.99 +/- 1.48, 1.40 +/- 0.95, 0.65 +/- 0.61) in comparison to tramadol (2.97 +/- 2.35, 2.37 +/- 1.45, 1.89 +/- 1.16, 0.87 +/- 0.50) and placebo (5.53 +/- 2.22, 3.33 +/- 1.37, 2.41 +/- 1.19, 1.19 +/- 0.56). Significantly less fentanyl was consumed in the gabapentin group (221.16 +/- 52.39 micro g) than in the tramadol (269.60 +/- 44.17 micro g) and placebo groups (355.86 +/- 42.04 micro g; P < 0.05). Sedation (33.98%), nausea/retching/vomiting (24.8%) were the commonest side effects in the gabapentin group whereas respiratory depression (3.9%) was the commonest in the tramadol group and vertigo (7.8%) in the placebo group.

CONCLUSION

Preemptive use of gabapentin significantly decreases postoperative pain and rescue analgesic requirement in laparoscopic cholecystectomy.

摘要

目的

评估加巴喷丁和曲马多对腹腔镜胆囊切除术术后疼痛及芬太尼需求的比较性超前镇痛效果。

方法

459例美国麻醉医师协会（ASA）分级为I级和II级的患者，在全身麻醉下行腹腔镜胆囊切除术术前两小时，以双盲方式随机分配接受300mg加巴喷丁、100mg曲马多或安慰剂。术后，最初12小时内每两小时、之后12小时内每三小时用视觉模拟评分记录患者疼痛评分。患者按需静脉注射2μg·kg⁻¹芬太尼，记录每位患者的芬太尼总消耗量。

结果

与曲马多组（2.97±2.35、2.37±1.45、1.89±1.16、0.87±0.50）和安慰剂组（5.53±2.22、3.33±1.37、2.41±1.19、1.19±0.56）相比，加巴喷丁组患者在所有时间间隔的疼痛评分均显著更低（2.65±3.00、1.99±1.48、1.40±0.95、0.65±0.61）。加巴喷丁组的芬太尼消耗量（221.16±52.39μg）显著低于曲马多组（269.60±44.17μg）和安慰剂组（355.86±42.04μg；P<0.05）。加巴喷丁组最常见的副作用是镇静（33.98%）、恶心/干呕/呕吐（24.8%），而曲马多组最常见的是呼吸抑制（3.9%），安慰剂组是眩晕（7.8%）。