Syal Kartik, Goma Mandeep, Dogra Ravi K, Ohri Anil, Gupta Ashok K, Goel Ashok
Registrar, IGMC Shimla, India.
J Anaesthesiol Clin Pharmacol. 2010 Oct;26(4):531-6.
We carried out a study to evaluate the effects of protective premedication with Acetaminophen, Gabapentin and combination of Acetaminophen with Gabapentin on post-operative analgesia in patients undergoing open cholecys-tectomy under general anesthesia. PATIENTS #ENTITYSTARTX00026;
The study was conducted in a double-blind randomized and controlled manner in 120 consenting patients of either sex belonging to ASA physical status grade I and II, between the age groups of 20 to 50 years, weighing between 40 to 65 kg and undergoing elective surgery (open cholecystectomy) under general anesthesia. The patients were divided into 4 groups: 1: placebo, 2: Acetaminophen 1000 mg, 3: 1200 mg Gabapentin, 4: Acetaminphen 1000 mg plus 1200 mg Gabapentin. The drugs were given two hours before induction. Time, number and total amount of rescue analgesic (tramadol) and VAS score at rest and on movement. Side effects like any episode of nausea/vomiting and level of sedation were noted.
Premedication with antihyperalgesic and analgesic agents helps to decrease postoperative pain scores. Gabapentin premedication is effective for providing better postoperative pain relief with lower and delayed requirements of rescue analgesics, but causes more episodes of nausea and vomiting and higher levels of sedation.
我们开展了一项研究,以评估对乙酰氨基酚、加巴喷丁以及对乙酰氨基酚与加巴喷丁联合用药进行预防性预处理对全身麻醉下接受开腹胆囊切除术患者术后镇痛的效果。
本研究以双盲随机对照方式,纳入120例年龄在20至50岁之间、体重40至65千克、美国麻醉医师协会(ASA)身体状况分级为I级和II级、接受全身麻醉下择期手术(开腹胆囊切除术)的成年患者。患者被分为4组:1组:安慰剂组;2组:对乙酰氨基酚1000毫克组;3组:加巴喷丁1200毫克组;4组:对乙酰氨基酚1000毫克加加巴喷丁1200毫克组。药物在诱导前两小时给予。记录使用补救镇痛药(曲马多)的时间、次数和总量,以及静息和活动时的视觉模拟评分(VAS)。记录恶心/呕吐发作等副作用以及镇静水平。
使用抗痛觉过敏和镇痛药进行预处理有助于降低术后疼痛评分。加巴喷丁预处理能有效提供更好的术后疼痛缓解,减少补救镇痛药的使用且延迟使用需求,但会导致更多恶心呕吐发作和更高的镇静水平。