Tirault M, Foucan L, Debaene B, Frasca D, Lebrun T, Bernard J C, Sandefo I, Van Elstraete A C
Department of Anesthesiology, Clinique Saint-Paul, 97 200 Fort-de-France, Martinique, France.
Acta Anaesthesiol Belg. 2010;61(4):203-9.
Gabapentin reduces anxiety in psychiatric patients. In this prospective, randomized, double-blinded, placebo-controlled study, we investigated whether a single dose of gabapentin as a premedicant reduces preoperative anxiety, and improves patient satisfaction.
After Institutional Review Board approval and written consent, 210 patients were randomly allocated into 3 groups of oral premedication: placebo, hydroxyzine 75 mg, or gabapentin 1200 mg. Anxiety level was assessed 3 times, using a 100-mm visual analogue scale: before premedication, in the preoperative holding area, and just before induction of general anaesthesia. In the postoperative period, patients were asked about their satisfaction with their premedicant. Data were presented as mean +/- SD. VAS scores were analyzed by repeated-measures analysis of variance followed by a Bonferroni test as appropriate. The chi-square test was used to analyze categorical data. All p values less than 0.05 was considered statistically significant.
Baseline anxiety was not statistically different among the 3 groups. Anxiety level in the gabapentin group was significantly lower in the holding area, and before induction of anaesthesia (20 mm +/- 21), than in the hydroxyzine group (33 mm +/- 26 ; p = 0.023) and in the placebo group (36 mm +/- 28; p = 0.004). Anxiety decreased significantly overtime only in the gabapentin group. The gabapentin and hydroxyzine groups had a higher proportion of "satisfied or extremely satisfied" patients (73% and 70% respectively) as compared to the placebo group (48%, p = 0.006).
A single dose of gabapentin has proven to be an effective premedication to reduce preoperative anxiety.
加巴喷丁可减轻精神病患者的焦虑。在这项前瞻性、随机、双盲、安慰剂对照研究中,我们调查了单剂量加巴喷丁作为术前用药是否能减轻术前焦虑并提高患者满意度。
经机构审查委员会批准并获得书面同意后,将210例患者随机分为3组进行口服术前用药:安慰剂组、75mg羟嗪组或1200mg加巴喷丁组。使用100mm视觉模拟量表在3个时间点评估焦虑水平:术前用药前、术前等待区以及即将进行全身麻醉前。术后询问患者对术前用药的满意度。数据以均值±标准差表示。采用重复测量方差分析及适当的Bonferroni检验分析视觉模拟量表评分。使用卡方检验分析分类数据。所有p值小于0.05被认为具有统计学意义。
3组患者的基线焦虑无统计学差异。加巴喷丁组在等待区和麻醉诱导前的焦虑水平(20mm±21)显著低于羟嗪组(33mm±26;p = 0.023)和安慰剂组(36mm±28;p = 0.004)。仅加巴喷丁组的焦虑随时间显著降低。与安慰剂组(48%,p = 0.006)相比,加巴喷丁组和羟嗪组“满意或极其满意”的患者比例更高(分别为73%和70%)。
已证明单剂量加巴喷丁是一种有效的术前用药,可减轻术前焦虑。