Department of Anesthesia, Toronto Western Hospital, University of Toronto, 399 Bathurst Street, Toronto, Ontario, Canada.
Br J Anaesth. 2010 Aug;105(2):155-61. doi: 10.1093/bja/aeq116. Epub 2010 Jun 25.
The objective of this study was to examine the effects of low-dose pregabalin on the analgesic efficacy, side-effects, and recovery profile in patients undergoing laparoscopic cholecystectomy.
One hundred and sixty-two patients aged 18-65 yr, of ASA physical status I-III, undergoing elective outpatient laparoscopic cholecystectomy were recruited and randomized in this prospective, placebo-controlled, double-blind study to receive one of the following study medications orally: pregabalin 50 mg, pregabalin 75 mg, or placebo, 1 h before surgery and then every 12 h after operation for a total of three doses. Postoperative numeric pain scores, analgesic consumption, recovery score (QoR-40), and side-effects (opioid-related symptom distress scale) were assessed in the early postoperative period (every 15 min during the first hour, at 90, 120 min, 6, and 12 h) and at days 1, 2, and 7. Data were analysed using an intention-to-treat method.
Compared with the placebo group, the pain scores were lower in the pregabalin 75 mg group in the first 90 min after surgery (P<0.05). Pregabalin 50 mg resulted in pain reduction at 30 and 45 min (P<0.05) relative to placebo. The analgesic consumption, side-effects, and recovery scores were similar among the three groups.
Perioperative administration of pregabalin 75 mg provided limited analgesic benefit in the postoperative period. An updated meta-analysis confirms this finding (see Supplementary material).
本研究旨在探讨小剂量普瑞巴林对腹腔镜胆囊切除术患者的镇痛效果、副作用和恢复情况的影响。
本前瞻性、安慰剂对照、双盲研究纳入了 162 名年龄在 18-65 岁、ASA 身体状况 I-III 级、择期行门诊腹腔镜胆囊切除术的患者,并将其随机分为以下三组:普瑞巴林 50mg 组、普瑞巴林 75mg 组或安慰剂组,分别于术前 1 小时口服,然后每 12 小时一次,共 3 次。术后即刻(第 1 小时内每 15 分钟评估 1 次,第 90、120 分钟,第 6、12 小时)及第 1、2、7 天评估数字疼痛评分、镇痛药用量、恢复评分(QoR-40)和副作用(阿片类药物相关症状困扰量表)。采用意向治疗分析方法进行数据分析。
与安慰剂组相比,普瑞巴林 75mg 组术后前 90 分钟疼痛评分较低(P<0.05)。普瑞巴林 50mg 组与安慰剂组相比,术后 30 分钟和 45 分钟时疼痛评分降低(P<0.05)。三组间镇痛药用量、副作用和恢复评分相似。
围手术期给予普瑞巴林 75mg 可在术后提供有限的镇痛效果。一项更新的荟萃分析证实了这一发现(见补充材料)。