Han Chao, Kuang Ming-Jie, Ma Jian-Xiong, Ma Xin-Long
Department of Orthopedics, Tianjin Hospital, Hexi District Tianjin Medical University, Tianjin, China.
Medicine (Baltimore). 2017 Jun;96(26):e6947. doi: 10.1097/MD.0000000000006947.
Pain management after total knee arthroplasty (TKA) varies and has been investigated for years. Pregabalin as an anticonvulsant agent that selectively affects the nociceptive process has been used for pain relief after operation. This meta-analysis was conducted to examine the evidence of pregabalin in TKA.
Systematic searches of all related literatures were conducted using the following databases: MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials. Only randomized-controlled trials (RCTs) for TKA were included. The postoperative narcotic requirements, visual analog scale scores, knee flexion range, and relative risk of incidence rate of adverse effects in the pregabalin group versus placebo group were extracted throughout the study.
Seven placebo-controlled RCTs met the inclusion criteria. The use of pregabalin significantly decrease the postoperative total morphine consumption (P < .05) and increase the passive knee flexion range (P < .05). Compared with the control group, the incidence of some side effects (nausea, vomiting, pruritus, and constipation) was less in the pregabalin group (P < .05).
The administration of pregabalin is not only efficacious in the reduction of narcotic requirements and incidence of some adverse effect, but also workable for the improvement of passive knee flexion range after TKA.
全膝关节置换术（TKA）后的疼痛管理方法各异，多年来一直是研究对象。普瑞巴林作为一种选择性影响伤害感受过程的抗惊厥药物，已被用于术后镇痛。本荟萃分析旨在研究普瑞巴林用于全膝关节置换术的证据。
使用以下数据库对所有相关文献进行系统检索：医学文献数据库（MEDLINE）、荷兰医学文摘数据库（EMBASE）和Cochrane对照试验中心注册库。仅纳入全膝关节置换术的随机对照试验（RCT）。在整个研究过程中，提取普瑞巴林组与安慰剂组术后的麻醉药物需求量、视觉模拟量表评分、膝关节屈曲范围以及不良反应发生率的相对风险。
七项安慰剂对照的随机对照试验符合纳入标准。使用普瑞巴林可显著降低术后吗啡总消耗量（P < 0.05），并增加被动膝关节屈曲范围（P < 0.05）。与对照组相比，普瑞巴林组某些副作用（恶心、呕吐、瘙痒和便秘）的发生率较低（P < 0.05）。
普瑞巴林不仅能有效减少麻醉药物需求量和某些不良反应的发生率，还能改善全膝关节置换术后的被动膝关节屈曲范围。
