Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, South Korea.
Spine (Phila Pa 1976). 2011 Mar 15;36(6):428-33. doi: 10.1097/BRS.0b013e3181d26708.
A prospective, randomized, controlled, and double-blind trial.
To evaluate the effects of 2 different doses of perioperative pregabalin administration, twice on the day of surgery, on acute postoperative pain after spinal surgery.
Besides its well-established role on neuropathic pain, pregabalin seems to be a promising adjunct to multimodal analgesic regimen following surgery. No comprehensive data exist regarding the optimal dosage of pregabalin on reducing postoperative pain and opioid consumption in spinal surgery.
Patients were randomly assigned to 1 of 3 groups. The placebo group (n = 28) received placebo capsules 1 hour before the anesthetic induction and 12 hours after surgery. The pregabalin groups received pregabalin 75 mg (P75 group, n = 28) or 150 mg (P150 group, n = 28), respectively at the same points. Assessed variables were total amount of administered fentanyl-based intravenous patient-controlled analgesia, pain intensity, and the frequency of rescue analgesic administered during the first 48 hours after surgery, subdivided into the following 4 periods: on arrival of patient to the postanesthesia care unit, 1 to 6 hours, 6 to 24 hours, and 24 to 48 hours. RESULTS.: The amount of patient-controlled analgesia volume infused until 24 hours (P 5 0.025) and 48 hours (P 5 0.028) after surgery was significantly less in the P150 group compared with the control group. The frequency of additional anodynes administered until 6 hours (P 5 0.049) and 24 hours (P 5 0.045) after surgery was significantly less in the P150 group compared with the control group.
Perioperative administration of pregabalin 150 mg before and 12 hours after surgery, but not 75 mg, significantly reduced opioid consumption and the use of additional pain rescue for 48 hours after surgery without significant side effects in patients undergoing spinal fusion surgery.
前瞻性、随机、对照、双盲试验。
评估两种不同剂量的围手术期普瑞巴林给药方案（手术当天给药两次）对脊柱手术后急性术后疼痛的影响。
除了其在神经病理性疼痛方面的既定作用外，普瑞巴林似乎是手术后多模式镇痛方案的一种有前途的辅助手段。关于普瑞巴林在减少脊柱手术后的术后疼痛和阿片类药物消耗方面的最佳剂量，尚无全面数据。
患者被随机分配到 3 组中的 1 组。安慰剂组（n = 28）在麻醉诱导前 1 小时和手术后 12 小时给予安慰剂胶囊。普瑞巴林组分别给予普瑞巴林 75 毫克（P75 组，n = 28）或 150 毫克（P150 组，n = 28）。评估变量包括静脉自控镇痛的芬太尼总用量、疼痛强度以及术后 48 小时内给予的解救性镇痛的频率，分为以下 4 个时间段：患者到达麻醉后监护病房时、1 至 6 小时、6 至 24 小时和 24 至 48 小时。
与对照组相比，P150 组在术后 24 小时（P 5 0.025）和 48 小时（P 5 0.028）时输注的自控镇痛量显著减少。与对照组相比，P150 组在术后 6 小时（P 5 0.049）和 24 小时（P 5 0.045）时给予的额外镇痛药的频率显著降低。
在脊柱融合手术患者中，术前和术后 12 小时给予普瑞巴林 150 毫克，而不是 75 毫克，可显著减少术后 48 小时内阿片类药物的消耗和额外疼痛解救药物的使用，且无明显副作用。
