Gupta Prasoon, Saxena Anudeep, Chaudhary Lalita
Department of Critical Care and Emergency Medicine, Sir Ganga Ram Hospital, New Delhi, India.
Department of Anaesthesia, Lady Hardinge Medical College, New Delhi, India.
Anesth Essays Res. 2017 Apr-Jun;11(2):330-333. doi: 10.4103/0259-1162.186862.
Preoperative medication has a vital role in anesthesia. Pregabalin (PG) is a newer drug of gabapentinoid class and is six times more potent than gabapentin. Our study was designed to evaluate the effect of PG as premedication on the perioperative anesthetic requirement and analgesia.
The study was conducted on ninety patients of American Society of Anesthesiologists Grade I and II of age group 20-60 years, allocated to one of the three groups of thirty patients each. Group I received tablet diazepam 10 mg HS and 5 mg 1 h before surgery, Group II received capsule PG 75 mg HS and 150 mg 1 h before surgery, and Group III received capsule PG 75 mg HS and 300 mg 1 h before surgery. Patients were induced with injection fentanyl citrate, thiopentone sodium, and rocuronium bromide and maintained by 66% NO + 33% O gas mixture with sevoflurane and intermittent boluses of fentanyl.
Perioperative consumption of thiopentone sodium was 5.59 ± 0.49 mg/kg in Group I, 4.29 ± 0.53 mg/kg in Group II, and 4.06 ± 0.59 mg/kg in Group III; fentanyl was 1.55 ± 0.42 μg/kg in Group I, 1.00 ± 0.00 μg/kg in Group II, and 1.05 ± 0.20 μg/kg in Group III; sevoflurane (%) was 1.20 ± 0.31 in Group I, 0.933 ± 0.25 in Group II, and 1.00 ± 0.00 in Group III. Perioperative requirement of thiopentone sodium, opioid, and inhalational agent was significantly less in Group II and III when compared with Group I. Maximum number of patients required postoperative rescue analgesia within 0-2 h of surgery in Group I, 2-4 h of surgery in Group II, and 6-8 h after surgery in Group III. Patients were more comfortable and asleep with a longer pain-free postoperative period in PG groups.
PG premedication effectively reduced the consumption of all anesthetic agents during induction and maintenance of anesthesia as compared to diazepam. Patient's postoperative comfort and pain-free duration were also greater with PG premedication; more so with PG 300 mg as compared to PG 150 mg.
术前用药在麻醉中起着至关重要的作用。普瑞巴林(PG)是一种新型的加巴喷丁类药物,其效力比加巴喷丁强六倍。我们的研究旨在评估PG作为术前用药对围手术期麻醉需求和镇痛的影响。
本研究选取了90例年龄在20 - 60岁的美国麻醉医师协会I级和II级患者,分为三组,每组30例。第一组在术前晚服用10 mg地西泮片,术前1小时服用5 mg;第二组在术前晚服用75 mg PG胶囊,术前1小时服用150 mg;第三组在术前晚服用75 mg PG胶囊,术前1小时服用300 mg。患者采用枸橼酸芬太尼、硫喷妥钠和罗库溴铵注射液诱导麻醉,并通过66% NO + 33% O2气体混合七氟烷和间歇性推注芬太尼维持麻醉。
第一组硫喷妥钠的围手术期用量为5.59 ± 0.49 mg/kg,第二组为4.29 ± 0.53 mg/kg,第三组为4.06 ± 0.59 mg/kg;芬太尼用量第一组为1.55 ± 0.42 μg/kg,第二组为1.00 ± 0.00 μg/kg,第三组为1.05 ± 0.20 μg/kg;七氟烷浓度(%)第一组为1.20 ± 0.31,第二组为0.933 ± 0.25,第三组为1.00 ± 0.00。与第一组相比,第二组和第三组硫喷妥钠、阿片类药物和吸入性麻醉剂的围手术期需求量显著减少。第一组术后0 - 2小时内需要术后解救镇痛的患者最多,第二组在术后2 - 4小时,第三组在术后6 - 8小时。PG组患者术后更舒适,无痛期更长。
与地西泮相比,PG术前用药有效减少了麻醉诱导和维持期间所有麻醉药物的用量。PG术前用药患者的术后舒适度和无痛持续时间也更长;与150 mg PG相比,300 mg PG的效果更明显。