El Kenany S, El Tahan M R
Department of Anaesthesia and Surgical Intensive Care, College of Medicine, Mansoura University, Mansoura, Egypt.
Department of Anaesthesia and Surgical Intensive Care, College of Medicine, Mansoura University, Mansoura, Egypt.
Int J Obstet Anesth. 2016 May;26:24-31. doi: 10.1016/j.ijoa.2015.11.001. Epub 2015 Nov 12.
We hypothesised that preoperative administration of a single-dose of pregabalin would be associated with lower morphine consumption after uncomplicated caesarean delivery.
After Institutional Ethics Committee approval, 135 parturients scheduled for elective caesarean delivery under spinal anaesthesia were randomly allocated to receive either placebo, or oral pregabalin 150mg or 300mg, one hour before induction of anaesthesia. Maternal cumulative morphine requirement at 24h, pain scores, sedation scores, nausea and vomiting, pruritus, pregabalin-related adverse effects, Apgar scores, Neurologic and Adaptive Capacity scores and umbilical cord acid-base status were recorded.
Compared with placebo or pregabalin 150mg, the use of a preoperative dose of pregabalin 300mg resulted in significantly lower cumulative morphine consumption at 24h (mean dose: placebo 12.9mg [95% CI 11.6 to 14.2]; pregabalin 150mg 11.9mg; [95% CI 10.7 to 13.1]; pregabalin 300mg 6mg [95% CI 5.4 to 7.3]; P<0.001). Pregabalin 300mg resulted in lower pain scores at 4h and 6h after delivery (P<0.001), and fewer instances of nausea, vomiting and pruritus (P<0.009). Dizziness and abnormal vision were observed most frequently in the pregabalin 300mg group (P<0.05 and P<0.009, respectively). The three groups were similar in terms of maternal sedation, Apgar scores, Neurologic and Adaptive Capacity scores and umbilical cord acid-base status. Three babies in the pregabalin 300mg group (6.7%) experienced short-term poor latching-on for breastfeeding.
In our study, preoperative administration of pregabalin 300mg reduced postoperative morphine consumption and early postoperative pain in parturients undergoing elective caesarean delivery, although maternal side effects were more common.
我们假设术前单次给予普瑞巴林与无并发症剖宫产术后较低的吗啡消耗量相关。
经机构伦理委员会批准，135例计划在脊麻下行择期剖宫产的产妇在麻醉诱导前1小时被随机分配接受安慰剂、口服150mg或300mg普瑞巴林。记录产妇24小时吗啡累积需求量、疼痛评分、镇静评分、恶心呕吐、瘙痒、普瑞巴林相关不良反应、阿氏评分、神经和适应能力评分以及脐带酸碱状态。
与安慰剂或150mg普瑞巴林相比，术前给予300mg普瑞巴林导致24小时吗啡累积消耗量显著降低（平均剂量：安慰剂12.9mg [95%CI 11.6至14.2]；150mg普瑞巴林11.9mg；[CI 95% 10.7至13.1]；300mg普瑞巴林6mg [95%CI 5.4至7.3]；P<0.001）。300mg普瑞巴林使产后4小时和6小时疼痛评分降低（P<0.001），恶心、呕吐和瘙痒发生率降低（P<0.009）。300mg普瑞巴林组最常观察到头晕和视力异常（分别为P<0.05和P<0.009）。三组在产妇镇静、阿氏评分、神经和适应能力评分以及脐带酸碱状态方面相似。300mg普瑞巴林组有3例婴儿（6.7%）出现短期母乳喂养衔接不良。
在我们的研究中，术前给予300mg普瑞巴林可降低择期剖宫产产妇术后吗啡消耗量和术后早期疼痛，尽管产妇副作用更常见。
