Department of Anaesthesiology and Intensive Care Medicine, Helsinki University Hospital, PO BOX 340, FIN-00029 HUS Helsinki, Finland.
Br J Anaesth. 2011 Jun;106(6):873-81. doi: 10.1093/bja/aer083. Epub 2011 Apr 6.
In this prospective, randomized, double-blind, placebo-controlled study, we investigated the effect of pregabalin on oxycodone consumption, postoperative confusion, and pain in elderly cardiac surgery patients.
Seventy patients, aged ≥75 yr, were randomized to receive either 150 mg of pregabalin before operation and 75 mg of pregabalin twice daily for 5 postoperative days or placebo. Pain intensity was measured with the Verbal Rating Scale (VRS). When pain intensity was ≥2 on the VRS, patients received oxycodone either i.v. (0.05 mg kg(-1)) or orally (0.10-0.15 mg kg(-1)). Postoperative confusion was measured with the Confusion Assessment Method for the intensive care unit (CAM-ICU). Postoperative pain was assessed by a telephone interview 1 and 3 months after operation.
Cumulative consumption of parenteral oxycodone during 16 h after extubation was reduced by 44% and total oxycodone consumption from extubation to the end of the fifth postoperative day was reduced by 48% in the pregabalin group. Time to extubation was 138 min shorter and CAM-ICU scores were significantly lower on the first postoperative day in the placebo group, although there was no significant difference with respect to the Mini-Mental State Examination or the Richmond Agitation Sedation Score. The incidence of pain during movement was significantly lower in the pregabalin group at 3 months postoperative.
The administration of pregabalin reduced postoperative opioid consumption after cardiac surgery reduced the incidence of confusion on the first postoperative day and increased time to extubation when compared with placebo. Three months after operation, patients in the pregabalin group experienced less pain during movement.
在这项前瞻性、随机、双盲、安慰剂对照研究中，我们研究了普瑞巴林对老年心脏手术患者术后阿片类药物消耗、术后认知障碍和疼痛的影响。
70 名年龄≥75 岁的患者被随机分为两组，分别在术前接受 150 mg 普瑞巴林和术后 5 天内每天接受 75 mg 普瑞巴林治疗或安慰剂。疼痛强度采用言语评定量表（VRS）测量。当 VRS 评分≥2 时，患者给予静脉注射（0.05 mg/kg）或口服（0.10-0.15 mg/kg）羟考酮。术后认知障碍采用重症监护病房意识模糊评估法（CAM-ICU）进行评估。术后疼痛通过术后 1 个月和 3 个月的电话访谈进行评估。
与安慰剂组相比，拔管后 16 小时内静脉注射羟考酮的累积消耗量减少了 44%，从拔管到术后第 5 天结束时的总羟考酮消耗量减少了 48%。与安慰剂组相比，普瑞巴林组患者的拔管时间缩短了 138 分钟，术后第 1 天的 CAM-ICU 评分显著降低，但简易精神状态检查或 Richmond 躁动镇静评分无显著差异。术后 3 个月，普瑞巴林组患者活动时疼痛发生率显著降低。
与安慰剂相比，普瑞巴林可减少心脏手术后的术后阿片类药物消耗，降低术后第 1 天的认知障碍发生率，并延长拔管时间。术后 3 个月，普瑞巴林组患者活动时疼痛减轻。
