Sanders James G, Dawes Patrick J D
Department of Otolaryngology-Head and Neck Surgery, Waikato Hospital, Hamilton, New Zealand
Department of Otolaryngology-Head & Neck Surgery, Dunedin Hospital, Dunedin, New Zealand.
Otolaryngol Head Neck Surg. 2016 Dec;155(6):893-903. doi: 10.1177/0194599816659042. Epub 2016 Jul 26.
Recent research has investigated the role of gabapentin in perioperative pain relief in otorhinolaryngology-head and neck surgery. This review aims to identify whether sufficient evidence exists for the routine use of gabapentin in the perioperative setting.
MEDLINE, Cochrane CENTRAL, EMBASE, and Google Scholar.
A comprehensive systematic search was performed with keywords for articles up to November 2015. The systematic review included all randomized, placebo-, and active-controlled trials investigating the role of perioperative gabapentin for pain in otorhinolaryngology-head and neck surgery. The studies were assessed for risk of bias and selected and reviewed by the main author. Selected trials were required to have data in the form of pain intensity scores, analgesic consumption, adverse effects, or return to normal function.
A total of 14 randomized controlled trials were included, of which 4 had an active control. The placebo-controlled trials included 4 for tonsillectomy, 3 for rhinology, and 3 for thyroidectomy. These studies were not suitable for meta-analysis. Trial quality involving gabapentin in tonsillectomy surgery is variable. The higher-quality studies reported significantly reduced analgesic consumption in the gabapentin groups, with the effect on pain scores less clear. There was a significant benefit, within the first 24 hours, in pain and analgesic consumption as compared with placebo favoring the gabapentin groups following rhinologic and thyroid surgery.
Overall, gabapentin appears to have a significant beneficial effect on perioperative pain relief and analgesic consumption in otorhinolaryngology-head and neck surgery procedures within the first 24 hours.
近期研究探讨了加巴喷丁在耳鼻咽喉-头颈外科围手术期疼痛缓解中的作用。本综述旨在确定围手术期常规使用加巴喷丁是否有充分证据。
MEDLINE、Cochrane 中心对照试验注册库、EMBASE 和谷歌学术。
使用关键词对截至2015年11月的文章进行全面系统检索。系统综述纳入了所有调查围手术期加巴喷丁在耳鼻咽喉-头颈外科疼痛中作用的随机、安慰剂对照和活性药物对照试验。评估研究的偏倚风险，由第一作者进行选择和综述。入选试验需有疼痛强度评分、镇痛药消耗量、不良反应或恢复正常功能等形式的数据。
共纳入14项随机对照试验，其中4项有活性对照。安慰剂对照试验包括4项扁桃体切除术、3项鼻科手术和3项甲状腺切除术。这些研究不适合进行荟萃分析。扁桃体切除术中涉及加巴喷丁的试验质量参差不齐。质量较高的研究报告加巴喷丁组的镇痛药消耗量显著减少，对疼痛评分的影响不太明确。与安慰剂相比，在鼻科手术和甲状腺手术后的头24小时内，加巴喷丁组在疼痛和镇痛药消耗方面有显著益处。
总体而言，加巴喷丁在耳鼻咽喉-头颈外科手术的头24小时内，对围手术期疼痛缓解和镇痛药消耗似乎有显著有益作用。
