Department of Anaesthesia and Intensive Care Medicine, Cork University Hospital, Wilton, Cork, Ireland.
Anesth Analg. 2010 Apr 1;110(4):1180-5. doi: 10.1213/ANE.0b013e3181cf949a. Epub 2010 Jan 26.
Patient outcome after lumbar discectomy for radicular low back pain is variable and the benefit is inconsistent. Many patients continue to experience pain 3 months after surgery. Pregabalin, a membrane stabilizer, may decrease perioperative central sensitization and subsequent persistent pain.
Forty patients undergoing lumbar discectomy were randomly allocated to receive either pregabalin (300 mg at 90 minutes preoperatively and 150 mg at 12 and 24 hours postoperatively) or placebo at corresponding times in a double-blinded manner. Our primary outcome was the change in the present pain intensity (PPI) (visual analog scale [VAS], 0-100 mm [PPI-VAS, McGill Pain Questionnaire]) from preoperatively to 3 months postoperatively.
The decrease in PPI-VAS score at 3 months was greater in patients who received pregabalin (37.6 +/- 19.6 mm) (mean +/- sd) than those who received placebo (25.3 +/- 21.9 mm) (P = 0.08). The Roland Morris disability score at 3 months was less in patients who received pregabalin (2.7 +/- 2.4) than in those who received placebo (5.6 +/- 4.8) (P = 0.032). Pregabalin administration was associated with greater pain tolerance thresholds in both lower limbs compared with placebo at 24 hours postoperatively.
Perioperative pregabalin administration is associated with less pain intensity and improved functional outcomes 3 months after lumbar discectomy.
接受神经根性下腰痛腰椎间盘切除术的患者的预后各不相同，且获益并不一致。许多患者在手术后 3 个月仍会持续疼痛。普瑞巴林是一种膜稳定剂，可能会减少围手术期中枢敏化和随后的持续性疼痛。
40 例行腰椎间盘切除术的患者被随机分为两组，分别接受普瑞巴林（术前 90 分钟给予 300mg，术后 12 小时和 24 小时分别给予 150mg）或安慰剂治疗，两组均采用双盲法。我们的主要结局是从术前到术后 3 个月时的现有疼痛强度（PPI）变化（视觉模拟量表[VAS]，0-100mm[PPI-VAS，麦吉尔疼痛问卷]）。
接受普瑞巴林治疗的患者（37.6 +/- 19.6mm）的 PPI-VAS 评分在术后 3 个月时下降幅度大于接受安慰剂治疗的患者（25.3 +/- 21.9mm）（P = 0.08）。接受普瑞巴林治疗的患者（2.7 +/- 2.4）的 Roland Morris 残疾评分在术后 3 个月时低于接受安慰剂治疗的患者（5.6 +/- 4.8）（P = 0.032）。与安慰剂相比，术后 24 小时时，普瑞巴林组的双侧下肢疼痛耐受阈值更高。
围手术期普瑞巴林给药与腰椎间盘切除术后 3 个月时疼痛强度减轻和功能结局改善相关。
