Hema Vadakkoot Raghavan, Ramadas Konnanath Thekkethil, Biji Kannammadathy Poulose, Indu Suseela, Arun Aravind
Department of Anaesthesiology, Government Medical College, Kozhikode, Kerala, India.
Anesth Essays Res. 2017 Jul-Sep;11(3):718-723. doi: 10.4103/aer.AER_250_16.
Effective management of postoperative pain is a part of well-organized perioperative care, which helps in reduced morbidity and improved patient satisfaction. Preventive analgesia can reduce acute and chronic pain by blocking the noxious inputs to pain pathways, preventing sensitization. Studies have reported efficacy of gabapentin as a preventive analgesic in perioperative pain. In this study, we aimed to determine whether preoperative gabapentin reduced postoperative pain and tramadol consumption after thyroidectomy under general anesthesia.
Sixty patients scheduled for thyroidectomy were allocated to two groups of thirty each for this prospective, observational study. Patients in Group A and Group B received oral gabapentin 600 mg (6 × 10 kg) and diazepam 10 mg (1 × 10 kg), respectively, 2 h prior to surgery. Tramadol was given as rescue analgesic for postoperative pain with a verbal rating score of two. The analgesic efficacy of preoperative gabapentin was assessed in terms of postoperative pain scores at rest or swallowing, time to first rescue analgesic, and total tramadol consumption for 24 h. Ramsay sedation score and side effects of drug were also looked into.
Postoperative pain scores and total tramadol consumption were significantly lower in Group A during 24 h ( = 0.00). Time to first rescue analgesic was significantly prolonged in Group A ( = 0.001). Side effects were comparable.
Oral gabapentin is effective as a preventive analgesic in reducing postoperative pain and tramadol consumption after thyroidectomy under general anesthesia.
有效的术后疼痛管理是精心组织的围手术期护理的一部分，有助于降低发病率并提高患者满意度。预防性镇痛可通过阻断疼痛通路的有害输入来减少急性和慢性疼痛，防止敏化。研究报告了加巴喷丁作为围手术期疼痛预防性镇痛药的疗效。在本研究中，我们旨在确定术前加巴喷丁是否能减轻全身麻醉下甲状腺切除术后的疼痛并减少曲马多的用量。
本前瞻性观察性研究将60例计划行甲状腺切除术的患者分为两组，每组30例。A组和B组患者分别在手术前2小时口服600毫克（6×10千克）加巴喷丁和10毫克（1×10千克）地西泮。术后疼痛视觉模拟评分达到2分时给予曲马多作为解救镇痛药。通过静息或吞咽时的术后疼痛评分、首次使用解救镇痛药的时间以及24小时内曲马多的总用量来评估术前加巴喷丁的镇痛效果。同时观察Ramsay镇静评分和药物副作用。
A组术后24小时的疼痛评分和曲马多总用量显著更低（P = 0.00）。A组首次使用解救镇痛药的时间显著延长（P = 0.001）。两组副作用相当。
口服加巴喷丁作为预防性镇痛药可有效减轻全身麻醉下甲状腺切除术后的疼痛并减少曲马多用量。
