Parikh Harshel G, Dash Sananta Kumar, Upasani Chitra B
Department of Anesthesia & Critical Care, Grant Medical College & Sir J.J. Group of Hospitals, Mumbai-08, India.
Saudi J Anaesth. 2010 Sep;4(3):137-41. doi: 10.4103/1658-354X.71409.
To study the effect of oral gabapentin used as preemptive analgesia to attenuate post operative pain in patients undergoing abdominal surgery under general anesthesia.
In a randomized double blind study, 60 patients were divided into two groups. Group A received 600mg gabapentin and group B oral received placebo 1 h prior to surgery. Anesthesia was induced with Propofol 2 mg/kg and Vecuronium 0.1mg/kg and maintained with 60% N(2)O in O(2) and Vecuronium 0.02 mg/kg. All cases were given Fentanyl 2µg/kg as pre medication and a repeat dose 1µg/kg at the end of the first hour. Assessment of post-operative pain was made with the visual analog score (VAS) at extubation (0 h), 2, 4, 6, 12, and 24 h post-operatively. Post-operative analgesia was provided with intravenous Tramadol. The first dose was given in the Post Anesthesia Care Unit as 2mg/kg, and repeated at 8 and 16 h. Rescue analgesia was given with Diclofenac 1.5mg/kg, slow intravenous. The number of doses of rescue analgesia in both the groups was noted.
The VAS scores at 0, 2, 4, 6, 12, and 24 h were 1.9 vs. 2.4 (P=0.002), 2.3 vs. 3.0 (P=0.000), 3.2 vs. 3.7 (P=0.006), 2.9 vs. 4.4 (P=0.000), 3.6 vs. 4.6 (P=0.000), and 3.7 vs.4.6 (P=0.000), respectively. Numbers of patients requiring rescue analgesia with Diclofenac were 3 vs. 14 (P=0.004).
A single oral dose of gabapentin given pre-operatively enhanced the analgesic effect of Tramadol as it also reduced the requirement of rescue analgesia with Diclofenac.
研究口服加巴喷丁作为超前镇痛对全身麻醉下腹部手术患者术后疼痛的缓解作用。
在一项随机双盲研究中,60例患者被分为两组。A组在手术前1小时口服600mg加巴喷丁,B组口服安慰剂。采用丙泊酚2mg/kg和维库溴铵0.1mg/kg诱导麻醉,并用60%氧化亚氮和氧气混合气体及维库溴铵0.02mg/kg维持麻醉。所有病例术前均给予芬太尼2μg/kg,在第1小时末重复给予1μg/kg。术后通过视觉模拟评分(VAS)在拔管时(0小时)、术后2、4、6、12和24小时评估疼痛情况。术后镇痛采用静脉注射曲马多。首剂在麻醉后护理单元给予2mg/kg,并在8小时和16小时重复给药。使用双氯芬酸1.5mg/kg缓慢静脉注射进行补救镇痛。记录两组补救镇痛的剂量数。
0、2、4、6、12和24小时的VAS评分分别为1.9对2.4(P =0.002)、2.3对3.0(P =0.000)、3.2对3.7(P =0.006)、2.9对4.4(P =0.000)、3.6对4.6(P =0.000)和3.7对4.6(P =0.000)。需要用双氯芬酸进行补救镇痛的患者人数为3对14(P =0.004)。
术前单次口服加巴喷丁增强了曲马多的镇痛效果,同时也减少了双氯芬酸补救镇痛的需求。