Department of Cardiovascular Surgery, GATA Haydarpasa Education Hospital, Istanbul, Turkey.
J Cardiothorac Vasc Anesth. 2011 Oct;25(5):824-9. doi: 10.1053/j.jvca.2010.11.017. Epub 2011 Jan 12.
The purpose of this study was to evaluate the analgesic effects of perioperative gabapentin on postoperative acute and chronic pain after coronary artery bypass graft (CABG) surgery with median sternotomy and internal mammary artery harvesting.
A double-blind randomized clinical study.
A single-academic hospital.
Patients with ischemic heart disease who were scheduled to undergo CABG surgery.
Forty patients were allocated randomly into 2 groups; the gabapentin group (n = 20) received 1.2 g/d of oral gabapentin before and for 2 days after surgery, and the placebo group (n = 20) received a placebo capsule instead. The primary outcome was to evaluate the effects of gabapentin on acute and chronic pain after surgery. The postoperative evaluation included the assessment of pain at rest and when coughing, intravenous tramadol usage, postoperative morbidities, and side effects of gabapentin. Postoperative analgesia at 6, 12, 18, 24, 48, and 72 hours after extubation and at discharge was evaluated with the visual analog scale. The assessment of postoperative pain at the 1- and 3-month follow-ups was performed using a numeric rating scale.
Postoperative pain scores at 1, 2, and 3 days were significantly lower in the gabapentin group when compared with the placebo group (p < 0.05). Pain scores at 1 and 3 months postoperatively were lower in the gabapentin group than in the placebo group (p > 0.05). Consumption of intravenous tramadol given as rescue analgesic within 24 hours after extubation in the gabapentin group was 99.0 ± 53.8 mg versus 149.4 ± 72.5 mg in the placebo group (p < 0.05). There were no differences in the incidence of side effects and time to extubation between the groups.
Gabapentin significantly reduced the intensity of pain and tramadol consumption in the early postoperative period after CABG surgery. Pain scores at 1 and 3 months after surgery were low in both groups, with no significant difference between the groups.
本研究旨在评估围手术期加巴喷丁对经正中胸骨切开和内乳动脉采集的冠状动脉旁路移植术（CABG）后急性和慢性疼痛的镇痛效果。
双盲随机临床试验。
一家学术型医院。
计划接受 CABG 手术的缺血性心脏病患者。
40 名患者被随机分为 2 组；加巴喷丁组（n=20）在术前和术后 2 天内每天口服 1.2 g 加巴喷丁，安慰剂组（n=20）给予安慰剂胶囊。主要结局是评估加巴喷丁对术后急性和慢性疼痛的影响。术后评估包括评估静息时和咳嗽时的疼痛、静脉注射曲马多的使用、术后并发症以及加巴喷丁的副作用。拔管后 6、12、18、24、48 和 72 小时以及出院时用视觉模拟评分法评估术后镇痛，术后 1 个月和 3 个月随访时用数字评分量表评估术后疼痛。
与安慰剂组相比，加巴喷丁组术后第 1、2 和 3 天的术后疼痛评分显著降低（p<0.05）。加巴喷丁组术后 1 个月和 3 个月的疼痛评分低于安慰剂组（p>0.05）。拔管后 24 小时内静脉注射曲马多作为解救性镇痛，加巴喷丁组用量为 99.0±53.8mg，安慰剂组用量为 149.4±72.5mg（p<0.05）。两组的副作用发生率和拔管时间无差异。
加巴喷丁可显著减轻 CABG 术后早期疼痛强度和曲马多的消耗。两组术后 1 个月和 3 个月的疼痛评分均较低，组间无显著差异。
