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预先给予普瑞巴林对腹腔镜胆囊切除术后疼痛强度和术后吗啡用量的影响。

Effect of pre-emptive pregabalin on pain intensity and postoperative morphine consumption after laparoscopic cholecystectomy.

机构信息

Department of Anesthesiology, University Hospital of Larissa, Biopolis, Larissa 411 10, Greece.

出版信息

Surg Endosc. 2013 Jul;27(7):2504-11. doi: 10.1007/s00464-012-2769-3. Epub 2013 Jan 24.

Abstract

BACKGROUND

Postoperative pain is the dominant complaint and the most common cause of delayed discharge after laparoscopic cholecystectomy. The aim of this study is to evaluate the potential of preoperative administration of pregabalin to reduce postoperative pain and opioid consumption.

METHODS

Fifty American Society of Anesthesiologists (ASA) I and II adult patients with symptomatic gallstone disease scheduled for elective laparoscopic cholecystectomy were randomized into two groups: group I patients (n = 25) were given 600 mg pregabalin per os divided in two doses, the night before surgery and 1 h preoperatively, respectively, while group II patients (n = 25) received a matching to pregabalin placebo at the same scheme. Postoperative pain, morphine consumption, and complications were compared between the two groups.

RESULTS

Postoperative pain (static and dynamic assessment) was significantly less at 0, 1, 8, 16, and 24 h (p < 0.001) after the procedure for group I (pregabalin) compared with the placebo group. Postoperative patient-controlled morphine consumption during hospital stay was also significantly less in the pregabalin group compared with the placebo group. Side-effects were similar in both groups expect for dizziness, which was significantly higher (p < 0.0001) in the pregabalin group.

CONCLUSIONS

Administration of 600 mg pregabalin per os, divided in two preoperative doses, significantly reduces postoperative pain as well as opioid consumption in patients undergoing laparoscopic cholecystectomy, at the cost of increased incidence of dizziness.

摘要

背景

术后疼痛是腹腔镜胆囊切除术后患者延迟出院的主要原因,也是最常见的原因。本研究旨在评估术前给予普瑞巴林(pregabalin)是否可能减轻术后疼痛和减少阿片类药物的使用。

方法

50 名美国麻醉医师学会(ASA)I 级和 II 级、患有症状性胆囊疾病并计划接受择期腹腔镜胆囊切除术的成年患者被随机分为两组:I 组(n=25)患者分别在手术前夜和术前 1 小时口服 600mg 普瑞巴林,分为两次给药,而 II 组(n=25)患者在相同方案下接受匹配的普瑞巴林安慰剂。比较两组患者的术后疼痛、吗啡用量和并发症。

结果

与安慰剂组相比,I 组(普瑞巴林组)患者在术后 0、1、8、16 和 24 小时(p<0.001)时的术后静息和动态疼痛明显减轻。普瑞巴林组患者在住院期间的术后自控吗啡用量也明显少于安慰剂组。除头晕外,两组的副作用相似,而头晕在普瑞巴林组的发生率明显更高(p<0.0001)。

结论

术前口服 600mg 普瑞巴林,分为两次剂量,可显著减轻腹腔镜胆囊切除术患者的术后疼痛和阿片类药物的使用,但会增加头晕的发生率。

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