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[术前使用普瑞巴林对子宫切除术后疼痛强度及吗啡需求量的影响]

[Effect of pre-emptive pregabalin on pain intensity and morphine requirement after hysterectomy].

作者信息

Przesmycki Krzysztof, Wiater-Kozioł Ewa, Kotarski Jan, Czuczwar Mirosław, Jaskowiak Robert, Zabek Marta, Kołacz Agnieszka, Fijałkowska Magdalena, Kotus Marzena

机构信息

II Klinika Anestezjologii i Intensywnej Terapii, Uniwersytet Medyczny w Lublinie.

出版信息

Anestezjol Intens Ter. 2011 Jan-Mar;43(1):14-7.

Abstract

BACKGROUND

Pregabalin, an antiepileptic and chronic pain medication, has been used by various authors for preoperative analgesia. We have assessed the effect of pre-emptive administration of the drug to patients scheduled for elective abdominal hysterectomy.

METHODS

Seventy-four ASA I and II patients were included in this prospective, double blind study. They were randomised to receive 75, 150, or 300 mg of pregabalin, or 7.5 mg of midazolam as a placebo, one hour before anaesthesia and surgery. Anaesthesia was induced with propofol and maintained with sevoflurane or desflurane. Fentanyl was used for analgesia and rocuronium for muscle relaxation. Immediately after surgery, patients received morphine intravenously in 2 mg increments until the NRS score was below 3. This was then followed by PCA.

RESULTS

Morphine consumption and pain scores were only significantly lower in the 300 mg pregabalin group, when compared to the placebo and other treatment groups; there were no differences between placebos and lower doses of pregabalin.

CONCLUSION

We conclude that pre-emptive administration of 300 mg pregabalin reduces postoperative pain and morphine consumption. Further studies on higher doses would appear to be justified.

摘要

背景

普瑞巴林是一种抗癫痫和慢性疼痛药物,已有多位作者将其用于术前镇痛。我们评估了对计划行择期腹部子宫切除术的患者预先给予该药物的效果。

方法

本前瞻性、双盲研究纳入了74例美国麻醉医师协会(ASA)分级为I级和II级的患者。他们被随机分为在麻醉和手术前1小时接受75毫克、150毫克或300毫克普瑞巴林,或7.5毫克咪达唑仑作为安慰剂。麻醉诱导采用丙泊酚,维持采用七氟烷或地氟烷。芬太尼用于镇痛,罗库溴铵用于肌肉松弛。术后患者立即静脉注射吗啡,每次增量2毫克,直至数字疼痛评分(NRS)低于3分。然后采用患者自控镇痛(PCA)。

结果

与安慰剂组和其他治疗组相比,仅300毫克普瑞巴林组的吗啡消耗量和疼痛评分显著更低;安慰剂组与低剂量普瑞巴林组之间无差异。

结论

我们得出结论,预先给予300毫克普瑞巴林可减轻术后疼痛并减少吗啡消耗量。对更高剂量进行进一步研究似乎是合理的。

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