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加巴喷丁能否减轻关节镜下肩袖修复术后疼痛?一项前瞻性、随机、双盲研究。

Can gabapentin help reduce postoperative pain in arthroscopic rotator cuff repair? A prospective, randomized, double-blind study.

机构信息

Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, South Korea.

出版信息

Arthroscopy. 2010 Sep;26(9 Suppl):S106-11. doi: 10.1016/j.arthro.2009.11.010. Epub 2010 May 5.

Abstract

PURPOSE

The aim of the study was to determine the effect of low-dose gabapentin on postoperative pain management in patients undergoing arthroscopic rotator cuff repair.

METHODS

This randomized, double-blinded, placebo-controlled study included 46 patients. The patients were divided into 2 groups according to the drug administered 2 hours before surgery, either 300 mg of gabapentin or placebo. The primary outcome measure was the visual analog scale (VAS) score at 2, 6, 12, and 24 hours postoperatively. The secondary outcome measures were fentanyl consumption and side effects during the first 2 hours in the postanesthesia care unit and then at 6 and 24 hours postoperatively. The patients were evaluated for side effects including nausea, vomiting, respiratory depression, dizziness, drowsiness, voiding difficulty, and pruritus.

RESULTS

The VAS scores at 2, 6, and 12 hours postoperatively were significantly lower in the gabapentin group than in the placebo group (P = .023, P = .019, and P = .022, respectively). The consumption of fentanyl, over a period of 24 hours, was not different in the comparisons between the groups (P = .686). The incidence of side effects was similar in the 2 groups.

CONCLUSIONS

A single dose of 300 mg of gabapentin reduced the VAS score during the first 24 hours postoperatively in patients undergoing shoulder arthroscopic rotator cuff repair, without significant side effects when compared with placebo. However, the fentanyl consumption did not differ between the gabapentin and placebo groups.

LEVEL OF EVIDENCE

Level I, randomized controlled trial.

摘要

目的

本研究旨在确定小剂量加巴喷丁对接受关节镜肩袖修复术患者术后疼痛管理的影响。

方法

这是一项随机、双盲、安慰剂对照研究,纳入了 46 名患者。根据手术前 2 小时给予的药物将患者分为两组,分别为 300 毫克加巴喷丁或安慰剂。主要结局测量指标为术后 2、6、12 和 24 小时的视觉模拟量表(VAS)评分。次要结局测量指标为术后麻醉后护理单元内的前 2 小时芬太尼消耗和副作用,然后在术后 6 和 24 小时进行评估。评估患者的副作用,包括恶心、呕吐、呼吸抑制、头晕、嗜睡、排尿困难和瘙痒。

结果

术后 2、6 和 12 小时,加巴喷丁组的 VAS 评分明显低于安慰剂组(P =.023、P =.019 和 P =.022)。两组在 24 小时内芬太尼的消耗无差异(P =.686)。两组的副作用发生率相似。

结论

单次给予 300 毫克加巴喷丁可降低接受肩关镜肩袖修复术患者术后 24 小时内的 VAS 评分,与安慰剂相比,无明显副作用。然而,加巴喷丁和安慰剂组的芬太尼消耗无差异。

证据水平

I 级,随机对照试验。

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