Mishra Atul, Nar Amandeep Singh, Bawa Ashvind, Kaur Gurinder, Bawa Sayesha, Mishra Seema
Professor, Department of Surgery, Dayanand Medical College and Hospital , Ludhiana, Punjab, India .
J Clin Diagn Res. 2013 Aug;7(8):1659-61. doi: 10.7860/JCDR/2013/5707.3239. Epub 2013 Aug 1.
Chronic post-thoracotomy pain (CPP) has very high incidence and therefore it needs attention. Usually, it is burning, dysaesthetic and aching in nature and it displays many features of neuropathic pain. No one technique of thoracotomy has been shown to reduce the incidence of chronic post thoracotomy pain.
To evaluate the efficacy and safety of pregabalin in patients with chronic post-thoracotomy pain.
This prospective, randomized study was conducted on 50 consenting patients who underwent posterolateral thoracotomy. 25 patients were given pregabalin for 21 days (Group A). Another 25 were given diclofenac sodium (Group B) on demand and they escaped treatment. Visual Analogue Scale (VAS) scoring was performed on days 0, 1 and 7, then follow up was done at 3, 6, 12 and 24 weeks. The data was analyzed by using t-test and Chi- square test for various variables.
The pain VAS scores in Group A were significantly low at all observation points except on day 0, day 1 and day 7 post-operatively, when the difference in pain scores in both the groups were comparable. The overall pain scores of Group A were comparable at day 0, day 1 and at day 7 as compared to those of Group B (p>0.9). Pain was significantly low at three weeks (p<0.05). Pain scores of Group A were significantly low at 6 weeks,12 weeks and 24 weeks as compared to those of Group B (p<0.001) and the difference was statistically significant. No significant adverse reactions were observed during study period.
Pregabalin is a safe and an effective adjuvant which is used for reducing the chronic post thoracotomy pain, which has no side effects and a high patient compliance. These results should be supported with multidisciplinary studies with larger sample sizes and longer follow-ups.
开胸术后慢性疼痛（CPP）发病率很高，因此需要引起关注。通常，其性质为灼痛、感觉异常和酸痛，并表现出许多神经性疼痛的特征。尚无一种开胸手术技术被证明可降低开胸术后慢性疼痛的发生率。
评估普瑞巴林对开胸术后慢性疼痛患者的疗效和安全性。
本前瞻性随机研究对50例接受后外侧开胸手术的同意参与患者进行。25例患者服用普瑞巴林21天（A组）。另外25例按需服用双氯芬酸钠（B组），且未接受其他治疗。在第0、1和7天进行视觉模拟评分（VAS），然后在第3、6、12和24周进行随访。对各种变量采用t检验和卡方检验分析数据。
A组的疼痛VAS评分在术后第0、1和7天除外的所有观察点均显著较低，此时两组的疼痛评分差异相当。与B组相比，A组在第0、1和7天的总体疼痛评分相当（p>0.9）。术后三周时疼痛显著减轻（p<0.05）。与B组相比，A组在第6、12和24周的疼痛评分显著较低（p<0.001），差异具有统计学意义。研究期间未观察到明显不良反应。
普瑞巴林是一种安全有效的辅助药物，可用于减轻开胸术后慢性疼痛，无副作用且患者依从性高。这些结果应通过更大样本量和更长随访时间的多学科研究来支持。
