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加巴喷丁预处理对乳腺癌手术中丙泊酚用量、血流动力学变量及术后疼痛缓解的影响。

Effect of gabapentin pretreatment on propofol consumption, hemodynamic variables, and postoperative pain relief in breast cancer surgery.

作者信息

Bharti Neerja, Bala Indu, Narayan Vidhya, Singh Gurpreet

机构信息

Department of Anesthesia and Intensive Care, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

出版信息

Acta Anaesthesiol Taiwan. 2013 Mar;51(1):10-3. doi: 10.1016/j.aat.2013.03.009. Epub 2013 May 3.

Abstract

STUDY OBJECTIVE

Gabapentin is an inhibitory neurotransmitter of the central nervous system. This prospective randomized double-blind study was conducted to evaluate the effects of gabapentin on intraoperative propofol requirements, hemodynamic variables, and postoperative pain relief in breast cancer patients.

MATERIALS AND METHODS

Forty adult females of the American Society of Anesthesiologists (ASA) Grade I-II physical status, undergoing total mastectomy for breast cancer were included. Patients were randomly allocated into two groups. Two hours prior to surgery the gabapentin group received gabapentin 600 mg and the control group received placebo. Anesthesia was induced with intravenous fentanyl, propofol, and vecuronium, and maintained with propofol infusion titrated according to the bispectral index. Postoperative analgesia was provided with intramuscular diclofenac sodium and intravenous morphine on demand.

RESULTS

The intraoperative propofol consumption was significantly less in the gabapentin group as compared with the control group (p = 0.009), whereas there was no difference in fentanyl and vecuronium requirements. Patients in the gabapentin group had lower pain scores at 30 minutes, 1 hour, and 2 hours postoperatively (p < 0.001). The postoperative morphine consumption was also less in the gabapentin group compared with the control group (p = 0.006). No significant adverse effects were noticeable.

CONCLUSION

Preoperative administration of gabapentin reduced intraoperative propofol requirements and postoperative analgesic consumption in breast cancer patients undergoing total mastectomy.

摘要

研究目的

加巴喷丁是一种中枢神经系统抑制性神经递质。本前瞻性随机双盲研究旨在评估加巴喷丁对乳腺癌患者术中丙泊酚需求量、血流动力学变量及术后疼痛缓解的影响。

材料与方法

纳入40例美国麻醉医师协会(ASA)分级为I-II级身体状况、行乳腺癌全乳切除术的成年女性患者。患者被随机分为两组。手术前两小时,加巴喷丁组接受600mg加巴喷丁,对照组接受安慰剂。静脉注射芬太尼、丙泊酚和维库溴铵诱导麻醉,并根据脑电双频指数滴定输注丙泊酚维持麻醉。术后根据需要给予肌肉注射双氯芬酸钠和静脉注射吗啡镇痛。

结果

与对照组相比,加巴喷丁组术中丙泊酚消耗量显著减少(p = 0.009),而芬太尼和维库溴铵需求量无差异。加巴喷丁组患者术后30分钟、1小时和2小时的疼痛评分较低(p < 0.001)。与对照组相比,加巴喷丁组术后吗啡消耗量也较少(p = 0.006)。未观察到明显的不良反应。

结论

术前给予加巴喷丁可减少行全乳切除术的乳腺癌患者术中丙泊酚需求量和术后镇痛药物消耗量。

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