加巴喷丁预防性使用预防琥珀酰胆碱诱导的肌束震颤和肌痛：一项随机、双盲、安慰剂对照研究。

Prophylactic use of gabapentin for prevention of succinylcholine-induced fasciculation and myalgia: a randomized, double-blinded, placebo-controlled study.

作者信息

Pandey C K, Tripathi M, Joshi G, Karna S T, Singh N, Singh P K

机构信息

Department of Anesthesiology, Institute of Liver and Biliary Sciences, New Delhi, India.

出版信息

J Postgrad Med. 2012 Jan-Mar;58(1):19-22. doi: 10.4103/0022-3859.93248.

DOI:10.4103/0022-3859.93248

PMID:22387644

Abstract

BACKGROUND

Succinylcholine is used for rapid-sequence induction of anesthesia. Fasciculations and myalgia are adverse effects. The pretreatment modalities prevent or minimize its adverse effects.

AIMS

The present study is designed to evaluate the efficacy of gabapentin on the incidence of fasciculation and succinylcholine-induced myalgia.

SETTINGS AND DESIGN

The study was conducted at a tertiary care teaching hospital in a randomized, double-blinded, placebo-controlled manner.

MATERIALS AND METHODS

Patients of both genders undergoing laparoscopic cholecystectomy were randomly assigned to two groups. Patients in Group I (Gabapentin group) received 600 mg of gabapentin orally 2 h prior to surgery and patients in Group II (placebo group) received matching placebo. Anesthesia was induced with fentanyl 3 μg/kg, thiopentone 3-5 mg/kg and succinylcholine 1.5 mg/kg. All patients were observed and graded for fasciculations by a blinded observer and patients were intubated. Anesthesia was maintained with oxygen in air, sevoflurane and intermittent vecuronium bromide. After completion of surgery, neuromuscular blockade was reversed. A blinded observer recorded myalgia grade at 24 h. Patients were provided patient-controlled analgesia with fentanyl for postoperative pain relief.

STATISTICAL ANALYSIS

Demographic data, fasciculation grade, fentanyl consumption, and myalgia grade were compared using student t test and test of proportions.

RESULTS

The study included 76 American Society of Anesthesiologists' Grade I or II patients of either gender undergoing laparoscopic cholecystectomy. But only 70 patients completed the study. Results demonstrated that the prophylactic use of gabapentin significantly decreases the incidence and the severity of myalgia (20/35 vs. 11/35) (P<0.05) and decreases fentanyl consumption significantly in the study group (620+164 μg vs. 989+238 μg) (P<0.05) without any effects on the incidence and severity of fasciculations.

CONCLUSIONS

Prophylactic use of gabapentin 600 mg in laparoscopic cholecystectomy decreases the incidence and severity of myalgia and fentanyl consumption.

摘要

背景

琥珀酰胆碱用于麻醉的快速顺序诱导。肌束震颤和肌痛是其不良反应。预处理方式可预防或减轻其不良反应。

目的

本研究旨在评估加巴喷丁对肌束震颤发生率及琥珀酰胆碱诱导的肌痛的疗效。

设置与设计

本研究在一家三级护理教学医院以随机、双盲、安慰剂对照的方式进行。

材料与方法

接受腹腔镜胆囊切除术的男女患者被随机分为两组。第一组（加巴喷丁组）患者在手术前2小时口服600毫克加巴喷丁，第二组（安慰剂组）患者接受匹配的安慰剂。用3微克/千克芬太尼、3 - 5毫克/千克硫喷妥钠和1.5毫克/千克琥珀酰胆碱诱导麻醉。由一名盲法观察者对所有患者的肌束震颤进行观察和分级，然后进行气管插管。用空气、氧气、七氟醚和间断性维库溴铵维持麻醉。手术结束后，逆转神经肌肉阻滞。一名盲法观察者记录24小时时的肌痛分级。为患者提供芬太尼患者自控镇痛以缓解术后疼痛。

统计分析

使用学生t检验和比例检验比较人口统计学数据、肌束震颤分级、芬太尼用量和肌痛分级。

结果

本研究纳入了76例接受腹腔镜胆囊切除术的美国麻醉医师协会I或II级男女患者。但只有70例患者完成了研究。结果表明，预防性使用加巴喷丁可显著降低肌痛的发生率和严重程度（20/35 vs. 11/35）（P<0.05），并显著降低研究组的芬太尼用量（620 + 164微克 vs. 989 + 238微克）（P<0.05），而对肌束震颤的发生率和严重程度无任何影响。