Kohli Monica, Murali T, Gupta Rajni, Khan Parveez, Bogra Jaishri
Assistant Professor, Dept. of Anaesthesiology, Chhatrapathi Shahuji Maharaj Medical Colege, Lucknow, India.
J Anaesthesiol Clin Pharmacol. 2011 Jan;27(1):101-5.
80% of patients undergoing surgical procedures experience postoperative pain1 and requires adequate pain relief. Nowadays drugs like COX2 inhibitors and calcium channel modulators (Pregabalin and Gabapentin) are been increasingly used for postoperative pain management effectively. We conducted this study to find whether preoperative pregabalin has any effect in postoperative analgesic requirement in patients undergoing hysterectomy under spinal anaesthesia. PATIENTS #ENTITYSTARTX00026;
This randomized, double-blind, placebo-controlled trial was conducted in 150 patients undergoing hysterectomy under spinal anaesthesia, divided in three groups - Group I (PO) - Control group, Group II (P150) received 150 mg pregabalin and Group III (P300) received 300 mg pregabalin. We used VAS for anxiety, Ramsay sedation scale and VAS for patient satisfaction regarding pain relief.
There was significant reduction in anxiety in groups P (150) and P (300) than placebo group P (0) during intraoperative and postoperative period than preoperative period. There was significant sedation seen in groups P (150) and P (300) than placebo group P (0). First rescue analgesia in group P (300) was202.42±6.77 and in group P (150) was176.38±4.80on average, group P (0) was131.38±5.15. Dizziness was 44.44% in group P (300), 36.11% in group P (150), and 19.44% in group P (0). Patient satisfaction was better in P (300) group than other two groups.
Pregabalin being an oral drug which would be easy for the patients to take and also its prolongation of the neuraxial block helps in immediate postoperative analgesia and further reduction of other parentral analgesics. Pregabalin 150mg would be the optimal preemptive dose for hysterectomy under spinal anaesthesia.
80%接受外科手术的患者会经历术后疼痛，且需要充分的疼痛缓解。如今，像COX2抑制剂和钙通道调节剂（普瑞巴林和加巴喷丁）等药物越来越多地被有效用于术后疼痛管理。我们开展这项研究以确定术前使用普瑞巴林对接受脊髓麻醉下子宫切除术患者的术后镇痛需求是否有任何影响。患者#实体开始X00026；
这项随机、双盲、安慰剂对照试验在150例接受脊髓麻醉下子宫切除术的患者中进行，分为三组——第一组（PO）——对照组，第二组（P150）接受150毫克普瑞巴林，第三组（P300）接受300毫克普瑞巴林。我们使用视觉模拟评分法评估焦虑程度、 Ramsay镇静评分以及患者对疼痛缓解的满意度的视觉模拟评分法。
与安慰剂组P（0）相比，在术中及术后阶段，P（150）组和P（300）组的焦虑程度较术前有显著降低。P（150）组和P（300）组出现的镇静作用比安慰剂组P（0）显著。P（300）组的首次补救性镇痛平均为202.42±6.77，P（150）组为176.38±4.80，P（0）组为131.38±5.15。P（300）组头晕发生率为44.44%，P（150）组为36.11%，P（0）组为19.44%。P（300）组患者满意度高于其他两组。
普瑞巴林作为一种口服药物，患者服用方便，其对神经轴阻滞的延长作用有助于术后即刻镇痛，并进一步减少其他非肠道镇痛药的使用。150毫克普瑞巴林将是脊髓麻醉下子宫切除术的最佳超前镇痛剂量。
