Montazeri K, Kashefi P, Honarmand A
Department of Anaesthesiology and Intensive Care Medicine, School of Medical Sciences, Isfahan University, Isfahan, Iran.
Singapore Med J. 2007 Aug;48(8):748-51.
Gabapentin has demonstrated analgesic effects in clinical trials as a preemptive analgesic and in acute postoperative pain management. This study was conducted to evaluate whether the pre-emptive use of gabapentin could reduce postoperative pain and morphine consumption in patients after lower extremity orthopaedic surgery.
70 ASA I and II patients were randomly assigned to receive 300 mg gabapentin or placebo in a double-blind manner two hours before surgery under general anaesthesia. Postoperatively, the pain was assessed on a visual analogue scale (VAS) at 2, 4, 12, and 24 hours at rest. Morphine 0.05 mg/kg intravenously was used to treat postoperative pain on patients' demand. Total morphine consumption in the first 24 hours after surgery was also recorded.
Patients in the gabapentin group had significantly lower VAS scores at all time intervals of 2, 4, 12, and 24 hours, than those in the placebo group (respectively, 55.50 [mean] +/- 15.80 [standard deviation], 57.30 +/- 19.30, 45.74 +/- 16.00, 44.60 +/- 17.64, versus 72.30 +/- 14.00, 70.50 +/- 18.13, 62.00 +/- 23.32, 66.50 +/- 25.70; p-value is less than 0.05). The total morphine consumed after surgery in the first 24 hours in the gabapentin group (15.43 +/- 2.54) was significantly less than in the placebo group (17.94 +/- 3.00; p-value is less than 0.05).
Pre-emptive use of gabapentin 300 mg orally significantly decreases postoperative pain and rescue analgesic requirements in patients who undergo lower extremity orthopaedic surgery.
加巴喷丁在临床试验中已证明作为一种超前镇痛药物以及在急性术后疼痛管理方面具有镇痛作用。本研究旨在评估术前使用加巴喷丁是否能减轻下肢骨科手术后患者的术后疼痛并减少吗啡用量。
70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于手术前两小时以双盲方式随机分配接受300毫克加巴喷丁或安慰剂。术后，于静息状态下在2、4、12和24小时通过视觉模拟评分法（VAS）评估疼痛程度。根据患者需求静脉注射0.05毫克/千克吗啡以治疗术后疼痛。同时记录术后首24小时内吗啡的总用量。
加巴喷丁组患者在2、4、12和24小时所有时间间隔的VAS评分均显著低于安慰剂组（分别为55.50[均值]±15.80[标准差]、57.30±19.30、45.74±16.00、44.60±17.64，对比72.30±14.00、70.50±18.13、62.00±23.32、66.50±25.70；p值小于0.05）。加巴喷丁组术后首24小时吗啡总用量（15.43±2.54）显著少于安慰剂组（17.94±3.00；p值小于0.05）。
术前口服300毫克加巴喷丁可显著减轻下肢骨科手术患者的术后疼痛并减少急救镇痛药物的需求。
