Yadav Ghanshyam, Behera Shailaja Shankar, Das Saurabh Kumar, Jain Gaurav, Choupoo Sujali, Raj Janak
Department of Anesthesiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.
Department of Neurosurgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.
J Anaesthesiol Clin Pharmacol. 2015 Apr-Jun;31(2):169-73. doi: 10.4103/0970-9185.155143.
Postsurgical pain is the leading complaint after laparoscopic cholecystectomy that may delay the postoperative recovery and hence we undertook a prospective randomized trial to analyze the role of flupirtine as a preemptive analgesic for postoperative pain relief in patients undergoing above surgery.
A total of 66 cases were randomly assigned to two groups to receive capsule flupirtine (200 mg) or capsule vitamin B complex administered orally, 2 h before the laparoscopic cholecystectomy surgery. Time to first analgesic requirement, assessment of postoperative pain in terms of visual analog score, and analgesic requirement postoperatively were measured as a primary outcome.
Time to first analgesic requirement was significantly prolonged in the flupirtine group as compared with the placebo group. There was significant pain reduction in early postoperative period (up to 4 h), but no changes occurred thereafter. Total analgesic requirement (including rescue analgesia) and side-effects were comparable between the groups except for higher sedation in flupirtine group.
Flupirtine is effective as a preemptive analgesic in providing adequate pain relief during the immediate postoperative period after laparoscopic cholecystectomy surgery. However, continuation of drug therapy postoperatively could possibly delineate its optimal analgesic profile more profoundly.
术后疼痛是腹腔镜胆囊切除术后最主要的主诉,可能会延迟术后恢复,因此我们进行了一项前瞻性随机试验,以分析氟吡汀作为超前镇痛药物在上述手术患者术后镇痛中的作用。
总共66例患者被随机分为两组,在腹腔镜胆囊切除术手术前2小时口服氟吡汀胶囊(200毫克)或复合维生素B胶囊。首次需要镇痛的时间、根据视觉模拟评分评估的术后疼痛以及术后的镇痛需求作为主要观察指标进行测量。
与安慰剂组相比,氟吡汀组首次需要镇痛的时间显著延长。术后早期(至4小时)疼痛明显减轻,但此后无变化。除氟吡汀组镇静作用较强外,两组的总镇痛需求(包括补救性镇痛)和副作用相当。
氟吡汀作为超前镇痛药物在腹腔镜胆囊切除术后即刻能有效提供充分的疼痛缓解。然而,术后继续药物治疗可能会更深刻地描绘出其最佳镇痛效果。