Jokela R, Ahonen J, Tallgren M, Haanpää M, Korttila K
Department of Anaesthesia and Intensive Care Medicine, Helsinki University Hospital, PO Box 140, Helsinki FI-00029 HUCH, Finland.
Br J Anaesth. 2008 Jun;100(6):834-40. doi: 10.1093/bja/aen098. Epub 2008 Apr 29.
Multimodal pain management has been suggested to improve postoperative analgesia. In this study, we evaluated the quality of analgesia in women undergoing day-case gynaecological laparoscopic surgery, after premedication with pregabalin 75 mg (P75) or 150 mg (P150), compared with diazepam 5 mg (D5). All patients were given ibuprofen 800 mg orally.
Altogether 90 consenting women were anaesthetized in a standardized fashion. Postoperative analgesia was provided by ibuprofen 800 mg twice a day with fentanyl i.v. on request in the recovery room (RR), and combination tablets with acetaminophen and codeine after the RR. The visual analogue scale (VAS) scores for pain and side-effects and the amounts of postoperative analgesics were recorded for 24 h after surgery. The areas under the curves (AUC) were calculated for the VAS scores for pain at rest, pain in motion, and pain at cough 1-8 and 1-24 h after surgery.
The median AUC values for VAS scores for pain at rest (P=0.048) and in motion (P=0.046) 1-8 h after surgery were lower in the P150 group than that in the D5 group. The amounts of rescue analgesics or the degree of drowsiness did not differ in the three study groups.
Analgesia was better after premedication with pregabalin 150 mg than after diazepam 5 mg, both with ibuprofen 800 mg, during the early recovery after day-case gynaecological laparoscopic surgery. Pregabalin 150 mg did not reduce the amount of postoperative analgesics required.
多模式疼痛管理已被建议用于改善术后镇痛。在本研究中,我们评估了在日间妇科腹腔镜手术的女性患者中,与5毫克地西泮(D5)相比,术前服用75毫克(P75)或150毫克(P150)普瑞巴林后的镇痛质量。所有患者均口服800毫克布洛芬。
总共90名同意参与的女性患者接受标准化麻醉。术后镇痛方案为每天两次口服800毫克布洛芬,在恢复室(RR)根据需要静脉注射芬太尼,RR之后给予对乙酰氨基酚和可待因复方片剂。记录术后24小时的疼痛视觉模拟量表(VAS)评分、副作用以及术后镇痛药用量。计算术后1 - 8小时和1 - 24小时静息痛、运动痛和咳嗽痛VAS评分的曲线下面积(AUC)。
术后1 - 8小时,P150组静息痛(P = 0.048)和运动痛(P = 0.046)的VAS评分AUC中位数低于D5组。三个研究组的补救镇痛药用量或嗜睡程度无差异。
在日间妇科腹腔镜手术后的早期恢复阶段,对于均服用800毫克布洛芬的患者,术前服用150毫克普瑞巴林后的镇痛效果优于服用5毫克地西泮。150毫克普瑞巴林并未减少所需的术后镇痛药用量。