Spence Dennis, Goff Jason, Mohan Erin, Bowen Kirsten, Osborne Lisa, Maye John
Uniformed Services University of the Health Sciences, Graduate School of Nursing, Nurse Anesthesia Program, Naval Medical Center, San Diego, California, USA.
AANA J. 2011 Aug;79(4 Suppl):S43-50.
Recent studies suggest gabapentin has opioid-sparing effects and may reduce acute postoperative pain. However, there is limited research on the efficacy of gabapentin when combined in a multimodal approach after shoulder arthroscopy under general anesthesia with an interscalene block. We conducted prospective, double-blind study of 70 patients who were randomized to receive either 300 mg of gabapentin or placebo 1 hour before surgery, then twice a day for 2 days. The primary outcome was average pain scores. Secondary outcomes included differences in morphine equivalents, adverse effects, and sleep patterns. No significant differences in pain scores were found on day 1 (gabapentin mean [SD], 4.23 [2.61], vs placebo, 4.61 [2.57]; P = .58) or day 2 (gabapentin, 4.26 [2.39], vs placebo, 4.03 [2.34]; P = .71). Total morphine equivalents on day 1 (gabapentin, 9.75 mg [6.58 mg], vs placebo, 9.52 mg [4.75 mg]; P = .88) and day 2 (gabapentin, 9.21 mg [6.66 mg], vs placebo, 6.93 mg [5.44 mg]; P = .17) were similar. Adverse effects and sleep patterns were similar (P > .05). These results suggest this dosing regimen of gabapentin is not efficacious in improving outcomes in patients undergoing shoulder arthroscopy under general anesthesia with an interscalene block.
近期研究表明，加巴喷丁具有节省阿片类药物的作用，可能减轻术后急性疼痛。然而，关于在全身麻醉联合肌间沟阻滞下行肩关节镜检查后采用多模式方法联合使用加巴喷丁的疗效，研究有限。我们对70例患者进行了前瞻性、双盲研究，这些患者被随机分为两组，一组在手术前1小时接受300毫克加巴喷丁，另一组接受安慰剂，然后每天两次，共2天。主要结局是平均疼痛评分。次要结局包括吗啡等效剂量的差异、不良反应和睡眠模式。在第1天（加巴喷丁组平均[标准差]为4.23[2.61]，安慰剂组为4.61[2.57]；P = 0.58）或第2天（加巴喷丁组为4.26[2.39]，安慰剂组为4.03[2.34]；P = 0.71），疼痛评分无显著差异。第1天（加巴喷丁组为9.75毫克[6.58毫克]，安慰剂组为9.52毫克[4.75毫克]；P = 0.88）和第2天（加巴喷丁组为9.21毫克[6.66毫克]，安慰剂组为6.93毫克[5.44毫克]；P = 0.17）的总吗啡等效剂量相似。不良反应和睡眠模式相似（P>0.05）。这些结果表明，这种加巴喷丁给药方案对改善在全身麻醉联合肌间沟阻滞下行肩关节镜检查患者的结局无效。
