Department of Anesthesiology and Reanimation, Faculty of Medicine, Ufuk University, Mevlana Bulvari (Konya Yolu), No: 86-88, 06520, Balgat, Ankara, Turkey.
Eur Arch Otorhinolaryngol. 2010 May;267(5):731-6. doi: 10.1007/s00405-009-1175-5. Epub 2009 Dec 10.
This study was aimed to compare the intraoperative sedative and perioperative analgesic drug requirements and the incidences of postoperative side effects on the patients who received preoperative gabapentin or placebo. Sixty patients undergoing nasal septal or nasal sinus surgery were included. The patients received either 600 mg gabapentin (Group G) or placebo (Group P) orally, 1 h before surgery. The scores for sedation and pain were recorded at 5, 15, 30, 45 and 60 min, intraoperatively and at 30 min, 1, 2, 4, 6, 9, 12, 16, 20, 24 h, postoperatively. Sedation was achieved with an IV bolus of propofol and continuous infusion of remifentanil. There were significant differences between gabapentin and placebo groups with regard to total consumptions of remifentanil (171.42 + or - 68 vs. 219.17 + or - 95 microg, respectively; P = 0.033) and propofol (59.45 + or - 36.08 vs. 104.14 + or - 54.98 mg, respectively; P = 0.001). Group G patients had significantly lower intraoperative VAS scores at all time points (P < 0.05). The anxiety score of Group G was better at all times (P < 0.05). All postoperative pain scores were lower in the Group G (P < 0.05). Time to first request for analgesic was 12.7 + or - 2.3 h in Group G, and 7.8 2.1 h in Group P (P < 0.0001). Total consumption of lornoxicam was lower in Group G (P < 0.004). We concluded that monitored anesthesia care combined with preoperative analgesia with a low dose of (600 mg) oral gabapentin is an efficient option with tolerable side effects for patients undergoing ear, nose and throat ambulatory surgery.
本研究旨在比较术前给予加巴喷丁或安慰剂对行鼻内或鼻窦手术患者术中镇静和围术期镇痛药物需求及术后不良反应发生率的影响。60 例行鼻中隔或鼻窦手术的患者被纳入本研究。患者术前 1 h 分别口服 600 mg 加巴喷丁(G 组)或安慰剂(P 组)。记录患者术中 5、15、30、45 和 60 min 及术后 30 min、1、2、4、6、9、12、16、20、24 h 的镇静和疼痛评分。术中给予依托咪酯静脉推注和瑞芬太尼持续输注以达到镇静效果。与安慰剂组相比,加巴喷丁组瑞芬太尼(171.42 ± 68 与 219.17 ± 95 μg,P = 0.033)和依托咪酯(59.45 ± 36.08 与 104.14 ± 54.98 mg,P = 0.001)总用量显著减少。G 组患者各时间点的术中视觉模拟评分(VAS)显著较低(P < 0.05)。G 组患者焦虑评分各时间点均较好(P < 0.05)。G 组患者各术后疼痛评分均较低(P < 0.05)。G 组患者首次要求镇痛的时间为 12.7 ± 2.3 h,P 组为 7.8 ± 2.1 h(P < 0.0001)。G 组患者洛索洛芬总用量较低(P < 0.004)。我们的结论是,在接受耳鼻喉科日间手术的患者中,监测麻醉管理联合术前镇痛和小剂量(600 mg)口服加巴喷丁是一种有效且副作用可耐受的选择。