Canihuante José, Molina Ian, Altermatt Fernando
Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Proyecto Epistemonikos, Santiago, Chile.
Proyecto Epistemonikos, Santiago, Chile; Departamento de Anestesiología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile. Email:
Medwave. 2017 Dec 27;17(9):e7115. doi: 10.5867/medwave.2017.09.7115.
Pregabalin is a structural analog of γ-aminobutyric acid that may have a role in acute pain management. It has been used in the perioperative context, but there is controversy regarding its real clinical utility.
To answer this question we used Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach.
We identified 21 systematic reviews including 77 randomized trials. We concluded the use of perioperative pregabalin in major surgeries probably does not produce a clinically important decrease in acute postoperative pain. Although it could decrease nausea, postoperative vomiting and opioid requirements, it also produces an increase in sedation.
普瑞巴林是γ-氨基丁酸的结构类似物，可能在急性疼痛管理中发挥作用。它已被用于围手术期，但关于其实际临床效用存在争议。
为回答这个问题，我们使用了Epistemonikos，这是最大的健康系统评价数据库，通过筛选多个信息来源（包括MEDLINE、EMBASE、Cochrane等）进行维护。我们从系统评价中提取数据，重新分析原始研究的数据，进行荟萃分析，并使用GRADE方法生成结果总结表。
我们识别出21项系统评价，包括77项随机试验。我们得出结论，在大手术中围手术期使用普瑞巴林可能不会使术后急性疼痛产生临床上重要的减轻。虽然它可能会减少恶心、术后呕吐和阿片类药物的需求，但也会增加镇静作用。
