单剂量预防性使用普瑞巴林对双颌手术后疼痛及阿片类药物用量的影响:一项随机对照试验
Effects of a Single-Dose of Pre-Emptive Pregabalin on Postoperative Pain and Opioid Consumption After Double-Jaw Surgery: A Randomized Controlled Trial.
作者信息
Ahiskalioglu Ali, İnce İlker, Aksoy Mehmet, Yalcin Ertan, Ahiskalioglu Elif Oral, Kilinc Adnan
机构信息
Assistant Professor, Department of Anesthesiology and Reanimation, Ataturk University School of Medicine, Erzurum, Turkey.
Assistant Professor, Department of Anesthesiology and Reanimation, Ataturk University School of Medicine, Erzurum, Turkey.
出版信息
J Oral Maxillofac Surg. 2016 Jan;74(1):53.e1-7. doi: 10.1016/j.joms.2015.09.008. Epub 2015 Sep 21.
PURPOSE
The effect of a single-dose of pre-emptive pregabalin is still unknown, although it is used as an adjuvant in controlling acute postoperative pain. The purpose of this study was to evaluate the effects of pre-emptive single-dose pregabalin on postoperative acute pain and 24-hour opioid consumption in patients who underwent double-jaw surgery.
PATIENTS AND METHODS
Forty patients (18 to 45 yr old; American Society of Anesthesiologists status I to II) for whom elective double-jaw surgery was planned under general anesthesia were included in this study, which had been planned as a prospective, randomized, and double-blinded study. Patients were randomly divided into 2 groups: the pregabalin group (n = 20) was given pregabalin 150 mg orally 1 hour before general anesthesia and the placebo group (n = 20) was given an oral placebo capsule. The groups were administered the routine general anesthesia protocol. Postoperative analgesia was performed intravenously in the 2 groups twice a day with dexketoprofen trometamol 50 mg and patient-controlled analgesia with fentanyl. Postoperative analgesia was evaluated using the visual analog scale (VAS). Fentanyl consumption, additional analgesia requirement, and side-effects were recorded during the first 24 hours after surgery. Descriptive and bivariate statistics were computed, and significance was set at a P value less than .05.
RESULTS
Compared with placebo, the VAS score was statistically lower in the pregabalin group during the early postoperative period (P < .05). The 24-hour opioid consumption was significantly higher in the placebo group compared with the pregabalin group (509.40 ± 261.56 vs. 260.10 ± 246.53 μq, respectively; P = .004). In addition, the analgesia requirement was statistically lower in the pregabalin group (P < .05). Nausea or vomiting was observed more often in the placebo group, whereas other side-effects were similar for the 2 groups.
CONCLUSION
A single 150-mg dose of pre-emptive pregabalin decreased postoperative opioid consumption in the first 24 hours after double-jaw surgery. Multimodal analgesia techniques that contain pre-emptive analgesia can be used successfully in preventing postoperative pain caused by orthognathic surgery.
目的
尽管单次剂量的预防性普瑞巴林被用作控制术后急性疼痛的辅助药物,但其效果仍不明确。本研究的目的是评估单次剂量的预防性普瑞巴林对接受双颌手术患者术后急性疼痛和24小时阿片类药物消耗量的影响。
患者与方法
本研究计划为一项前瞻性、随机、双盲研究,纳入了40例计划在全身麻醉下进行择期双颌手术的患者(年龄18至45岁;美国麻醉医师协会分级I至II级)。患者被随机分为2组:普瑞巴林组(n = 20)在全身麻醉前1小时口服150 mg普瑞巴林,安慰剂组(n = 20)给予口服安慰剂胶囊。两组均采用常规全身麻醉方案。两组术后镇痛均采用每日两次静脉注射50 mg右酮洛芬氨丁三醇以及芬太尼患者自控镇痛。使用视觉模拟量表(VAS)评估术后镇痛效果。记录术后首24小时内的芬太尼消耗量、额外镇痛需求及副作用。计算描述性和双变量统计量,显著性设定为P值小于0.05。
结果
与安慰剂组相比,普瑞巴林组术后早期的VAS评分在统计学上更低(P < 0.05)。安慰剂组的24小时阿片类药物消耗量显著高于普瑞巴林组(分别为509.40 ± 261.56与260.10 ± 246.53 μg;P = 0.004)。此外,普瑞巴林组的镇痛需求在统计学上更低(P < 0.05)。安慰剂组恶心或呕吐的发生率更高,而两组的其他副作用相似。
结论
单次150 mg剂量的预防性普瑞巴林可降低双颌手术后首24小时内的阿片类药物消耗量。包含预防性镇痛的多模式镇痛技术可成功用于预防正颌手术引起的术后疼痛。