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术前服用普瑞巴林对腰椎切开术后镇痛及白细胞介素的影响:前瞻性、随机、对照、双盲研究

Effect of preoperative pregabalin on analgesia and interleukins after lumbotomy: prospective, randomized, comparative, double-blind study.

作者信息

Santiago Ana Ellen Queiroz, Leal Plinio da Cunha, Moura Ed Carlos Rey, Salomão Reinaldo, Brunialti Milena Karina Coló, Sakata Rioko Kimiko

机构信息

Department of Anesthesia, Universidade Federal de São Paulo, São Paulo, Brazil,

出版信息

J Pain Res. 2019 Jan 11;12:339-344. doi: 10.2147/JPR.S189441. eCollection 2019.

Abstract

BACKGROUND

Pregabalin is an anticonvulsant and has been used for postoperative analgesia. This study aimed to assess the effect of a single preoperative dose of pregabalin for analgesia after nephrectomy.

METHODS

The study was prospective, randomized, comparative, and double-blinded, conducted in 40 kidney transplant donors, between 18 and 60 years, American Society of Anesthesia physical status I or II. Epidural anesthesia was performed with 15 mL of 0.5% ropivacaine single shot and general anesthesia with 3 µg/kg of fentanyl, propofol, atracurium, and sevoflurane, and 50% of oxygen without nitrous oxide. Patients in group 1 were administered 300 mg of pregabalin and those in group 2 were administered placebo, in identical capsules, 1 hour prior to surgery. Postoperative analgesia was supplemented with tramadol. The following parameters were assessed: pain intensity after 6 and 24 hours; pain threshold, from the thenar and peri-incisional region, analgesic supplementation; ILs (IL6, IL8, and IL10) prior to surgery and after 6 and 24 hours.

RESULTS

The pain intensity was lower with pregabalin after 24 hours (G1: 2.5±2.4, G2: 3.0±2.6). There was no difference in the sensitivity of the thenar and peri-incisional region after 6 and 24 hours; in the number of patients requiring supplementation (G1=15%, G2=45%); concentrations of IL-6, IL-8, and IL-10; and side effects (nausea, vomiting, dizziness, and pruritus).

CONCLUSION

Pregabalin in a single preoperative dose of 300 mg reduced pain intensity 24 hours after lumbotomy.

摘要

背景

普瑞巴林是一种抗惊厥药,已用于术后镇痛。本研究旨在评估术前单次剂量的普瑞巴林对肾切除术后镇痛的效果。

方法

本研究为前瞻性、随机、对照、双盲研究,纳入40例年龄在18至60岁之间、美国麻醉医师协会身体状况分级为I或II级的肾移植供体。采用15毫升0.5%罗哌卡因单次注射进行硬膜外麻醉,全身麻醉采用3微克/千克芬太尼、丙泊酚、阿曲库铵和七氟醚,以及50%氧气且无氧化亚氮。第1组患者在手术前1小时给予300毫克普瑞巴林,第2组患者给予相同胶囊的安慰剂。术后镇痛用曲马多补充。评估以下参数:术后6小时和24小时的疼痛强度;来自大鱼际和切口周围区域的疼痛阈值、镇痛补充情况;术前以及术后6小时和24小时的白细胞介素(IL6、IL8和IL10)。

结果

24小时后,使用普瑞巴林的患者疼痛强度较低(第1组:2.5±2.4,第2组:3.0±2.6)。术后6小时和24小时,大鱼际和切口周围区域的敏感性无差异;需要补充镇痛的患者数量无差异(第1组=15%,第2组=45%);IL-6、IL-8和IL-10的浓度无差异;副作用(恶心、呕吐、头晕和瘙痒)无差异。

结论

术前单次剂量300毫克的普瑞巴林可降低腰椎切开术后24小时的疼痛强度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/607b/6333154/90ffbbe34337/jpr-12-339Fig1.jpg

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