Department of Orthopedics, Tianjin Hospital, Tianjin City, China.
Tianjin Medical University, Tianjin, China.
Pain Physician. 2017 Nov;20(7):649-661.
Pain management after spinal surgery has been studied for years. Gabapentin is a third-generation antiepileptic drug that selectively affects the nociceptive process and has been used for pain relief after surgery. However, the relationship between gabapentin and postoperative pain in spinal surgery is still controversial.
To assess the efficacy of the pre-emptive use of gabapentin in spinal surgery.
A meta-analysis of randomized controlled studies.
The MEDLINE, EMBASE, ClinicalTrials.gov, and Web of Science databases were systematically searched.
This meta-analysis of randomized controlled trials (RCTs) was performed to compare the use of gabapentin with placebo in spinal surgery regarding to the following: the mean difference (MD) of postoperative opioid requirements, the changes of visual analog scale (VAS) scores in 2 groups, and the incidence rate of adverse effects. An electronic-based search of all related literatures was conducted, and only RCTs for spinal surgery were included. The MD of postoperative opioid requirements and VAS scores and the relative risk (RR) of the incidence rate of adverse effects in the gabapentin group versus the placebo group were extracted throughout the study.
Ten trials, involving 827 patients, met the inclusion criteria and were included in this meta-analysis. The total morphine consumption was significantly lower over the first 24 hours postoperatively in the gabapentin group (P < 0.05). The VAS scores at 2, 4, 6, 12, and 24 hours were less in the gabapentin group (P < 0.05). The incidence rate of vomiting, pruritus, and urinary retention was significantly less in the gabapentin groups (RR = 0.53, 95% CI 0.32-0.86, P < 0.05; RR = 0.38, 95% CI 0.22-0.66, P < 0.05; RR = 0.57, 95% CI 0.34-0.98, P < 0.05, respectively).
All of the studies we screened were published online except for unpublished articles. Only 10 RCTs met our inclusion criteria, so the sample size was still relatively small.
This meta-analysis suggests that the administration of gabapentin is effective in reducing postoperative opioid consumption, VAS scores, and some side effects after spinal surgery.
Gabapentin, analgesia, spinal surgery, meta-analysis, randomized controlled trials, visual analog scale score, side effect.
多年来，人们一直在研究脊柱手术后的疼痛管理。加巴喷丁是一种第三代抗癫痫药物，选择性地影响伤害感受过程，已被用于手术后的止痛。然而，加巴喷丁与脊柱手术术后疼痛之间的关系仍存在争议。
评估在脊柱手术中预防性使用加巴喷丁的疗效。
随机对照研究的荟萃分析。
系统检索 MEDLINE、EMBASE、ClinicalTrials.gov 和 Web of Science 数据库。
对随机对照试验（RCT）的荟萃分析比较了加巴喷丁与安慰剂在脊柱手术中的使用效果，包括以下方面：术后阿片类药物需求的均数差值（MD）、两组 VAS 评分的变化以及不良反应发生率。通过电子搜索所有相关文献，仅纳入脊柱手术的 RCT。整个研究过程中提取加巴喷丁组与安慰剂组术后阿片类药物需求 MD 和 VAS 评分以及不良反应发生率的相对风险（RR）。
符合纳入标准并纳入本荟萃分析的共有 10 项试验，涉及 827 名患者。加巴喷丁组术后 24 小时内总吗啡消耗量明显降低（P < 0.05）。加巴喷丁组术后 2、4、6、12 和 24 小时的 VAS 评分较低（P < 0.05）。加巴喷丁组呕吐、瘙痒和尿潴留的发生率明显较低（RR=0.53，95%CI 0.32-0.86，P < 0.05；RR=0.38，95%CI 0.22-0.66，P < 0.05；RR=0.57，95%CI 0.34-0.98，P < 0.05）。
我们筛选的所有研究都在网上发表，除了未发表的文章。只有 10 项 RCT 符合我们的纳入标准，因此样本量仍然相对较小。
这项荟萃分析表明，在脊柱手术后，加巴喷丁的给药可有效减少术后阿片类药物的消耗、VAS 评分和一些不良反应。
加巴喷丁、镇痛、脊柱手术、荟萃分析、随机对照试验、视觉模拟评分、不良反应。
