Departments of *Anesthesiology; and †Neurosurgery, Himalayan Institute of Medical Sciences, HIHT University, Swami Ram Nagar, Dehradun, India.
Spine (Phila Pa 1976). 2014 Mar 15;39(6):E363-8. doi: 10.1097/BRS.0000000000000185.
Prospective, double-blind study, randomized control trial.
To evaluate and compare the analgesic efficacy, adverse effects, and clinical utility of gabapentin and pregabalin in postoperative pain management, long-term functional outcome, and quality of life in patients undergoing spinal surgery.
Patient outcome after lumbar discectomy for radicular low back pain is variable and the benefit is inconsistent. The most common persistent symptoms are pain, motor deficit, and decreased functional status.
This study was conducted in 90 patients belonging to the 18 to 75 age group of either sex undergoing spinal surgery under general anesthesia. Group A received 300 mg of gabapentin, group B received 75 mg of pregabalin, whereas group C received placebo 1 dose 1 hour before surgery and 8 hourly for 7 days, thereafter. The outcome of postoperative static and dynamic pain and functional outcome was recorded using 3 questionnaires-visual analogue scale, Prolo functional and economic score, Oswestry Disability Index score from preoperative period to 3 months postoperatively.
Among the 3 groups, subjects receiving pregabalin showed consistently reduced static and dynamic pain intensity and also required lesser amount of rescue drug throughout the postoperative period. There was statistically significant difference (P < 0.05) in the Prolo score and Oswestry Disability Index score at all time intervals between group B and group C. Although, significant difference in the functional outcome between group A and group B was seen at 3 months.
Preoperative pregabalin administration is associated with less pain intensity and improved functional outcomes 3 months after lumbar discectomy followed by gabapentin and then placebo.
前瞻性、双盲研究、随机对照试验。
评估和比较加巴喷丁和普瑞巴林在脊柱手术后疼痛管理、长期功能结果和生活质量方面的镇痛效果、不良反应和临床应用。
腰椎间盘切除术治疗神经根性腰痛患者的预后各不相同，获益也不一致。最常见的持续症状是疼痛、运动功能障碍和功能状态下降。
本研究纳入了 90 名年龄在 18 至 75 岁之间的患者，均为接受全身麻醉下脊柱手术的患者。A 组给予 300 毫克加巴喷丁，B 组给予 75 毫克普瑞巴林，C 组在术前 1 小时和术后 7 天内每 8 小时给予安慰剂 1 次。使用视觉模拟量表、Prolo 功能和经济评分、Oswestry 残疾指数评分记录术后静息和动态疼痛以及功能结果，这些评分从术前到术后 3 个月进行记录。
在这 3 组中，接受普瑞巴林治疗的患者在整个术后期间显示出持续降低的静息和动态疼痛强度，并且需要较少的救援药物。B 组和 C 组在所有时间点的 Prolo 评分和 Oswestry 残疾指数评分均有统计学差异（P < 0.05）。虽然 A 组和 B 组在 3 个月时在功能结果上有显著差异。
与给予安慰剂和加巴喷丁相比，术前给予普瑞巴林可降低腰椎间盘切除术后 3 个月的疼痛强度和改善功能结果。
2 级。
