Department of Anesthesiology, Fasa University of Medical Sciences, Fasa, Iran.
Med Princ Pract. 2010;19(1):57-60. doi: 10.1159/000252836. Epub 2009 Dec 9.
To evaluate the effect of gabapentin on the incidence and severity of postoperative nausea and vomiting (PONV) after open cholecystectomy.
A total of 90 patients scheduled for elective open cholecystectomy were randomly assigned to either a gabapentin group (600 mg, 2 h before surgery) or a placebo group. For the analysis, 1 patient was excluded from the gabapentin group and 2 patients from the placebo group. A standard technique was used for anesthesia. Pethidine and metoclopramide were used for postoperative management of pain and nausea/vomiting, respectively. The prevalence of PONV, its severity (measured on visual analogue scale, VAS), and total pethidine and metoclopramide use in the first 24 h after the operation were recorded.
There were no demographic differences between the two groups. Of the 44 patients given gabapentin, 16 (36.6%) and 28 of 43 (65.2%) placebo patients developed PONV; the difference was statistically significant (p = 0.02). However, there was no difference in the severity of PONV between the gabapentin and placebo groups (p = 0.12). Gabapentin patients used less pethidine (28.33 +/- 129 mg) and metoclopramide (6.0 +/-6.3 mg) than the placebo group (35.1 +/- 15.1 and 9.33 +/- 7.1 mg, respectively). The differences were statistically significant (pethidine: p = 0.002, metoclopramide: p = 0.033). However, gabapentin did not reduce postoperative pain significantly (p = 0.096).
Our data show that gabapentin not only reduced PONV after open cholecystectomy, but also reduced the need for additional postoperative analgesics.
评估加巴喷丁对胆囊切除术患者术后恶心呕吐(PONV)发生率和严重程度的影响。
90 例行择期胆囊切除术的患者被随机分为加巴喷丁组(术前 2 小时给予 600mg)或安慰剂组。分析时,加巴喷丁组中有 1 例患者被排除,安慰剂组中有 2 例患者被排除。采用标准的麻醉技术,术后使用哌替啶和胃复安分别处理疼痛和恶心/呕吐。记录术后 24 小时内 PONV 的发生率、严重程度(视觉模拟量表,VAS)和哌替啶、胃复安的总用量。
两组患者在人口统计学方面无差异。接受加巴喷丁治疗的 44 例患者中,16 例(36.6%)和安慰剂组的 28 例(65.2%)发生 PONV,差异有统计学意义(p = 0.02)。但两组患者 PONV 的严重程度无差异(p = 0.12)。加巴喷丁组患者哌替啶(28.33 +/- 129mg)和胃复安(6.0 +/- 6.3mg)的用量少于安慰剂组(35.1 +/- 15.1 和 9.33 +/- 7.1mg,p 值分别为 0.002 和 0.033)。但加巴喷丁并未显著减轻术后疼痛(p = 0.096)。
本研究数据表明,加巴喷丁不仅能降低胆囊切除术后 PONV 的发生率,还能减少术后额外的镇痛药物需求。