Pandey C K, Karna S T, Tandon M, Pandey V K, Singh A
Department of Anaesthesiology, Institute of Liver and Biliary Sciences, New Delhi, India.
J Postgrad Med. 2014 Jan-Mar;60(1):16-20. doi: 10.4103/0022-3859.128801.
Succinylcholine a depolarizing muscle relaxant with rapid onset, predictable course and short duration of action is associated with myalgia.
The aim of this study is to evaluate the efficacy of pregabalin, gabapentin and diclofenac on the incidence and severity of succinylcholine-induced myalgia.
Tertiary Care Teaching Hospital.
A total of 120 patients undergoing laparoscopic cholecystectomy were randomly assigned into three groups: Pregabalin group received 150 mg of pregabalin, gabapentin group received 600 mg of gabapentin and diclofenac group received 100 mg of diclofenac sodium orally 2 h prior to surgery. Anesthesia was induced with fentanyl 3 μg/kg, propofol 2-2.5 mg/kg and succinylcholine 1.5 mg/kg and was maintained with oxygen with sevoflurane in the air and intermittent vecuronium bromide. A blinded observer recorded post-operative pain scores on visual analog scale at different time intervals and myalgia at 24 h. Post-operative pain relief was provided with fentanyl based patient-controlled analgesia. Fentanyl consumption in 24 h was recorded as a primary outcome.
Patients' characteristics and total fentanyl consumption were compared using one-way ANOVA followed by post-hoc test. Pain score was compared amongst the groups using Kruskal Wallis test.
The myalgia occurred in 15, 14 and 13 patients in pregabalin, gabapentin and diclofenac sodium group respectively (P > 0.85). Patients in diclofenac group had significantly higher fentanyl consumption (674.85 ± 115.58 μg) compared with pregabalin group (601.87 ± 129.57 μg) (95% confidence interval [CI] = 34.8-120.7) and gabapentin group (612.29 ± 105.12 μg) (95% CI = 14.9-170.5). However, there was no significant difference in fentanyl consumption between pregabalin and gabapentin groups (95% CI = -34.8-120.7). There was a significant difference in visual analog score at time points 12, 18 and 24 h among the study groups.
Pre-treatment with pregabalin, gabapentin and diclofenac had equal efficacy in reducing the incidence and severity of succinylcholine-induced myalgia. However, pre-treatment with pregabalin and gabapentin decreased post-operative pain scores and fentanyl consumption.
琥珀酰胆碱是一种去极化肌松药，起效迅速、作用过程可预测且作用持续时间短，与肌痛有关。
本研究旨在评估普瑞巴林、加巴喷丁和双氯芬酸对琥珀酰胆碱诱导的肌痛的发生率和严重程度的疗效。
三级护理教学医院。
总共120例行腹腔镜胆囊切除术的患者被随机分为三组：普瑞巴林组在手术前2小时口服150毫克普瑞巴林，加巴喷丁组口服600毫克加巴喷丁，双氯芬酸组口服100毫克双氯芬酸钠。用3微克/千克芬太尼、2 - 2.5毫克/千克丙泊酚和1.5毫克/千克琥珀酰胆碱诱导麻醉，并用氧气、七氟醚和空气维持麻醉，间断给予维库溴铵。一名盲法观察者在不同时间间隔用视觉模拟量表记录术后疼痛评分，并在24小时记录肌痛情况。术后用基于芬太尼的患者自控镇痛法缓解疼痛。记录24小时内芬太尼的消耗量作为主要结局指标。
使用单因素方差分析及事后检验比较患者特征和芬太尼总消耗量。使用Kruskal Wallis检验比较各组间的疼痛评分。
普瑞巴林组、加巴喷丁组和双氯芬酸钠组分别有15例、14例和13例患者发生肌痛（P > 0.85）。双氯芬酸组患者的芬太尼消耗量（674.85 ± 115.58微克）显著高于普瑞巴林组（601.87 ± 129.57微克）（95%置信区间[CI] = 34.8 - 120.7）和加巴喷丁组（612.29 ± 105.12微克）（95% CI = 14.9 - 170.5）。然而，普瑞巴林组和加巴喷丁组之间的芬太尼消耗量无显著差异（95% CI = -34.8 - 120.7）。研究组在12、18和24小时时间点的视觉模拟评分有显著差异。
普瑞巴林、加巴喷丁和双氯芬酸预处理在降低琥珀酰胆碱诱导的肌痛的发生率和严重程度方面具有同等疗效。然而，普瑞巴林和加巴喷丁预处理可降低术后疼痛评分和芬太尼消耗量。
