Ménigaux Christophe, Adam Frédéric, Guignard Bruno, Sessler Daniel I, Chauvin Marcel
*Department of Anesthesia, Hôpital Ambroise Paré, Assistance Publique Hôpitaux de Paris, Paris, France; †Outcomes Research™ Institute, Department of Anesthesiology, University of Louisville, Louisville, Kentucky.
Anesth Analg. 2005 May;100(5):1394-1399. doi: 10.1213/01.ANE.0000152010.74739.B8.
Gabapentin has antihyperalgesic and anxiolytic properties. We thus tested the hypothesis that premedication with gabapentin would decrease preoperative anxiety and improve postoperative analgesia and early postoperative knee mobilization in patients undergoing arthroscopic anterior cruciate ligament repair under general anesthesia. Forty patients were randomly assigned to receive 1200 mg oral gabapentin or placebo 1-2 h before surgery; anesthesia was standardized. Patients received morphine, 0.1 mg/kg, 30 min before the end of surgery and postoperatively via a patient-controlled pump. Pain scores and morphine consumption were recorded over 48 h. Degrees of active and passive knee flexion and extension were recorded during physiotherapy on days 1 and 2. Preoperative anxiety scores were less in the gabapentin than control group (visual analog scale scores of 28 +/- 16 mm versus 66 +/- 15 mm, respectively; P < 0.001). The gabapentin group required less morphine than the control group (29 +/- 22 mg versus 69 +/- 40 mg, respectively; P < 0.001). Visual analog scale pain scores at rest and after mobilization were significantly reduced in the gabapentin group. First and maximal passive and active knee flexions at 24 and 48 h were significantly more extensive in the gabapentin than in the control group. In conclusion, premedication with 1200 mg gabapentin improved preoperative anxiolysis, postoperative analgesia, and early knee mobilization after arthroscopic anterior cruciate ligament repair.
加巴喷丁具有抗痛觉过敏和抗焦虑特性。因此，我们检验了这样一个假设：在全身麻醉下行关节镜下前交叉韧带修复术的患者中，术前使用加巴喷丁进行预处理可降低术前焦虑，改善术后镇痛及术后早期膝关节活动度。40例患者被随机分配，在手术前1 - 2小时口服1200毫克加巴喷丁或安慰剂；麻醉方法标准化。患者在手术结束前30分钟及术后通过患者自控镇痛泵接受0.1毫克/千克的吗啡。记录48小时内的疼痛评分及吗啡用量。在术后第1天和第2天的物理治疗期间记录膝关节主动和被动屈伸的度数。加巴喷丁组术前焦虑评分低于对照组（视觉模拟量表评分分别为28±16毫米和66±15毫米；P < 0.001）。加巴喷丁组所需吗啡量少于对照组（分别为29±22毫克和69±40毫克；P < 0.001）。加巴喷丁组静息及活动后的视觉模拟量表疼痛评分显著降低。加巴喷丁组在24小时和48小时时的首次及最大被动和主动膝关节屈曲明显大于对照组。总之，术前使用1200毫克加巴喷丁进行预处理可改善关节镜下前交叉韧带修复术后的术前抗焦虑、术后镇痛及早期膝关节活动度。
