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单剂量预防性使用普瑞巴林和静脉注射布洛芬对腹腔镜胆囊切除术后阿片类药物消耗量及急性疼痛的影响

Effects of Single-Dose Preemptive Pregabalin and Intravenous Ibuprofen on Postoperative Opioid Consumption and Acute Pain after Laparoscopic Cholecystectomy.

作者信息

Karaca Omer, Pınar Huseyin U, Turk Emin, Dogan Rafi, Ahiskalioglu Ali, Solak Sezen K

机构信息

a Department of Anesthesiology and Reanimation , Baskent University School of Medicine , Konya , Turkey.

b Department of General Surgery , Baskent University School of Medicine , Konya , Turkey.

出版信息

J Invest Surg. 2019 Apr;32(3):189-195. doi: 10.1080/08941939.2017.1386738. Epub 2017 Nov 20.

Abstract

PURPOSE

Non-opioid medications as a part of multimodal analgesia has been increasingly suggested in the management of acute post-surgical pain. The present study was planned to compare the efficacy of the combination of pregabalin plus ıv ibuprofen.

METHODS

58 patients were included in this prospective, randomized, double-blinded study. The pregabalin group (Group P, n = 29) received 150 mg pregabalin, the pregabalin plus ibuprofen group (Gropu PI, n = 29) received 150 mg pregabalin and 400mg ıv ibuprofen before surgery. Postoperative fentanyl consumption, additional analgesia requirements and PACU stay were recorded. Postoperative analgesia was performed with patient-controlled IV fentanyl.

RESULTS

VAS scores in the group PI were statistically lower at PACU, 1and 2 hours at rest, at PACU, 1, 2, 4, 12 and 24 hours on movement compared to the group P (P < 0.05). Opioid consumption was statistically significantly higher in the group P compared to the group PI (130.17 ± 60.27 vs 78.45 ± 60.40 μq, respectively, P < 0.001) and reduced in the 4th 24 hours by 55% in group PI. Rescue analgesia usage was statistically significantly higher in the group P than in the group PI (16/29 vs 7/29, respectively, P < 0.001). Four patient in the group PI did not need any opioid drug. Besides, PACU stay was shorter in the group PI than the group P (10.62 ± 2.38 vs 15.59 ± 2.11 min, respectively, P < 0.001).

CONCLUSION

Preemptive pregabalin plus ıv ibuprofen in laparoscopic cholecystectomy reduced postoperative opioid consumption. This multimodal analgesic aproach generated lower pain scores in the postoperative period.

摘要

目的

非阿片类药物作为多模式镇痛的一部分,在急性术后疼痛管理中越来越受到推荐。本研究旨在比较普瑞巴林联合静脉注射布洛芬的疗效。

方法

58例患者纳入本前瞻性、随机、双盲研究。普瑞巴林组(P组,n = 29)术前接受150mg普瑞巴林,普瑞巴林加布洛芬组(PI组,n = 29)术前接受150mg普瑞巴林和400mg静脉注射布洛芬。记录术后芬太尼用量、额外镇痛需求和在麻醉后恢复室(PACU)的停留时间。术后镇痛采用患者自控静脉注射芬太尼。

结果

与P组相比,PI组在PACU、静息1小时和2小时、PACU、活动1小时、2小时、4小时、12小时和24小时时的视觉模拟评分(VAS)在统计学上更低(P < 0.05)。P组的阿片类药物用量在统计学上显著高于PI组(分别为130.17±60.27μg和78.45±60.40μg,P < 0.001),且PI组在第4个24小时减少了55%。P组的补救性镇痛使用在统计学上显著高于PI组(分别为16/29和7/29,P < 0.001)。PI组有4例患者不需要任何阿片类药物。此外,PI组在PACU的停留时间比P组短(分别为10.62±2.38分钟和15.59±2.11分钟,P < 0.001)。

结论

在腹腔镜胆囊切除术中,术前使用普瑞巴林联合静脉注射布洛芬可减少术后阿片类药物的用量。这种多模式镇痛方法在术后产生了更低的疼痛评分。

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