Pandey C K, Priye S, Ambesh S P, Singh S, Singh U, Singh P K
Department of Anaesthesiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow-226 014, India.
J Postgrad Med. 2006 Apr-Jun;52(2):97-100.
Gabapentin is an antiepileptic drug. Its antiemetic effect is demonstrated in chemotherapy-induced acute and delayed onset of nausea and vomiting in breast cancer patients.
To evaluate the antiemetic effect of gabapentin on incidence and severity of postoperative nausea and vomiting in laparoscopic cholecystectomy.
Double-blind, randomized, placebo-controlled study.
Two hundred and fifty patients of ASA physical status I and II, scheduled for laparoscopic cholecystectomy were randomly assigned into two equal groups to receive 600 mg gabapentin or matching placebo two hours before surgery. Standard anaesthesia technique was used. Fentanyl was used as rescue postoperative analgesic. Ondansetron 4 mg was used intravenously as rescue medication for emesis. The total number of patients who had nausea or vomiting, and its severity and total fentanyl consumption in the first 24 hours were recorded.
"Z test" was used to test the significance of severity of post-operative nausea and vomiting between groups. Fentanyl consumed in each group (Mean+/-SD) within 24 hrs was compared using student t test. P value < 0.05 was considered significant.
There were no demographic difference between the two groups. Incidence of post-operative nausea and vomiting within 24 hrs after laparoscopic cholecystectomy was significantly lower in gabapentin group (46/125) than in the placebo group (75/125) (37.8% vs 60%; P =0.04). There was a significantly decreased fentanyl consumption in gabapentin group (221.2+/-92.4 microg) as compared to placebo group (505.9+/-82.0 microg; P =0.01).
Gabapentin effectively suppresses nausea and vomiting in laparoscopic cholecystectomy and post-operative rescue analgesic requirement.
加巴喷丁是一种抗癫痫药物。其止吐作用已在乳腺癌患者化疗引起的急性和迟发性恶心呕吐中得到证实。
评估加巴喷丁对腹腔镜胆囊切除术后恶心呕吐发生率和严重程度的止吐效果。
双盲、随机、安慰剂对照研究。
250例美国麻醉医师协会（ASA）身体状况为I级和II级、计划行腹腔镜胆囊切除术的患者被随机分为两组，每组125例，在手术前两小时分别接受600毫克加巴喷丁或匹配的安慰剂。采用标准麻醉技术。芬太尼用作术后急救镇痛药。静脉注射4毫克昂丹司琼作为呕吐的急救药物。记录术后24小时内出现恶心或呕吐的患者总数、其严重程度以及芬太尼的总消耗量。
采用“Z检验”来检验两组之间术后恶心呕吐严重程度的差异。使用学生t检验比较每组在24小时内消耗的芬太尼（平均值±标准差）。P值<0.05被认为具有统计学意义。
两组之间在人口统计学方面无差异。加巴喷丁组（46/125）腹腔镜胆囊切除术后24小时内恶心呕吐的发生率显著低于安慰剂组（75/125）（37.8%对60%；P =0.04）。与安慰剂组（505.9±82.0微克）相比，加巴喷丁组的芬太尼消耗量显著降低（221.2±92.4微克；P =0.01）。
加巴喷丁可有效抑制腹腔镜胆囊切除术后的恶心呕吐以及术后急救镇痛需求。
