Department of Anaesthesia, Assistance Publique Hôpitaux de Paris, Hôpital Raymond Poincaré, Garches, France.
Anaesthesia. 2014 Jan;69(1):46-52. doi: 10.1111/anae.12495.
Ketamine and pregabalin each provide postoperative analgesia, although the combination has yet to be evaluated. One hundred and forty-two patients undergoing total hip arthroplasty were randomly assigned to receive ketamine alone, pregabalin alone, ketamine and pregabalin combined, or placebo. Pain scores at rest and on movement, morphine consumption, side-effects, pressure pain thresholds and secondary hyperalgesia were evaluated. Mean (SD) total 48-h morphine use was reduced in patients given ketamine alone (52 (22) mg) and pregabalin alone (44 (20) mg) compared with placebo (77 (36) mg) p < 0.001. Morphine use was further reduced in patients given both ketamine and pregabalin (38 (19) mg) with an interaction between ketamine and pregabalin (ANOVA factorial; p = 0.028). Secondary hyperalgesia was reduced by ketamine. There were no differences between groups in pain scores after surgery, pressure pain thresholds or side-effects. The combination of pregabalin and ketamine has a small, beneficial clinical effect.
氯胺酮和普瑞巴林均可提供术后镇痛效果，但其联合应用尚未得到评估。142 例行全髋关节置换术的患者被随机分为氯胺酮组、普瑞巴林组、氯胺酮和普瑞巴林联合组和安慰剂组。评估静息和运动时的疼痛评分、吗啡用量、副作用、压痛阈值和继发性痛觉过敏。与安慰剂组（77（36）mg）相比，单独给予氯胺酮（52（22）mg）和普瑞巴林（44（20）mg）的患者总 48 小时吗啡用量减少（p < 0.001）。联合使用氯胺酮和普瑞巴林的患者（38（19）mg）吗啡用量进一步减少，且氯胺酮和普瑞巴林之间存在交互作用（ANOVA 析因；p = 0.028）。氯胺酮可降低继发性痛觉过敏。术后各组疼痛评分、压痛阈值或副作用均无差异。普瑞巴林和氯胺酮联合具有较小的有益临床效果。
