Hurley Robert W, Cohen Steven P, Williams Kayode A, Rowlingson Andrew J, Wu Christopher L
Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins University, Baltimore, MD 21287, USA.
Reg Anesth Pain Med. 2006 May-Jun;31(3):237-47. doi: 10.1016/j.rapm.2006.01.005.
Gabapentin is an anticonvulsant that has been shown to be effective in the treatment of neuropathic and inflammatory pain in animal and human studies. The analgesic effect of its perioperative use has not been fully elucidated.
This systematic review (meta-analysis) included 12 randomized controlled trials of 896 patients undergoing a variety of surgical procedures that investigated the impact of perioperative administration of gabapentin on postoperative outcome.
The pooled visual analog scores for pain at 4 hours and 24 hours were significantly less in those patients who received gabapentin (weighted mean difference [WMD] = -1.57; 95% confidence interval [CI], -2.14 to -0.99 and WMD = -0.74; CI, -1.03 to -0.45, respectively). A concomitant decrease in opioid usage by those patients who received gabapentin was also noted (odds ratio [OR] = -17.84; CI, -23.50 to -12.18). Gabapentin administration was associated with sedation and anxiolysis (OR = 3.28; CI, 1.21-8.87) but not associated with a difference in lightheadedness, dizziness, nausea, or vomiting.
Based on this systematic review, perioperative oral gabapentin is a useful adjunct for the management of postoperative pain that provides analgesia through a different mechanism than opioids and other analgesic agents and would make a reasonable addition to a multimodal analgesic treatment plan.
加巴喷丁是一种抗惊厥药，在动物和人体研究中已显示出对神经性和炎性疼痛有效。其围手术期使用的镇痛效果尚未完全阐明。
本系统评价（荟萃分析）纳入了12项随机对照试验，共896例接受各种外科手术的患者，这些试验研究了围手术期给予加巴喷丁对术后结局的影响。
接受加巴喷丁治疗的患者在术后4小时和24小时的疼痛视觉模拟评分汇总值显著更低（加权平均差[WMD]=-1.57；95%置信区间[CI]，-2.14至-0.99；以及WMD=-0.74；CI，-1.03至-0.45）。还注意到接受加巴喷丁治疗的患者阿片类药物使用量随之减少（比值比[OR]=-17.84；CI，-23.50至-12.18）。给予加巴喷丁与镇静和抗焦虑作用相关（OR=3.28；CI，1.21 - 8.87），但与头晕、眩晕、恶心或呕吐方面的差异无关。
基于本系统评价，围手术期口服加巴喷丁是管理术后疼痛的有用辅助药物，它通过与阿片类药物和其他镇痛药不同机制提供镇痛作用，可合理地纳入多模式镇痛治疗方案。
