Security Forces Hospital, Kingdom of Saudi Arabia, Anesthesia, Riyadh, Saudi Arabia.
Robert Jones and Agnes Hunt Orthopaedic Hospital, UK.
Orthop Traumatol Surg Res. 2019 Dec;105(8):1487-1493. doi: 10.1016/j.otsr.2019.09.023. Epub 2019 Nov 3.
Arthroscopic shoulder surgery is increasingly performed as a day case procedure. Nausea, vomiting and inadequate pain control are the most frequent reasons for reattendance or failed discharge. Gabapentin is advocated as an adjunct to mitigate these symptoms and its use in shoulder arthroscopy may provide improved post-operative symptom control. The aim of this study was to perform a meta-analysis of studies evaluating the role of gabapentin in the peri-operative management of shoulder arthroscopy.
Gabapentin is associated with significant improvements in post-operative nausea, vomiting and pain control after shoulder arthroscopy.
A systematic review using Medline was conducted in accordance with the PRISMA guidelines. Randomised controlled trials studies reporting on patients >15 years old receiving either preoperative gabapentin or placebo before any shoulder arthroscopic surgery were considered for eligibility. Studies were appraised against the Consolidated Standards of Reporting Trials (CONSORT) checklist. A meta-analysis was performed using Review Manager 5.3.
Four randomized controlled trials were identified for inclusion (n=227). Meta-analysis demonstrated a beneficial effect of gabapentin in preventing nausea and vomiting in the postoperative period (Odds Ratio 0.30, p=0.04). However, pooled data analysis did not show significant advantage in using gabapentin for postoperative pain control (p=0.11), although one study demonstrated a significant reduction in opioid consumption after gabapentin. No significant difference was reported in post-operative dizziness or sedation between the groups.
Gabapentin did not show any significant benefit in postoperative pain control but is associated with significant reductions in post-operative nausea and vomiting after shoulder arthroscopy.
I, meta-analysis.
关节镜下肩部手术越来越多地作为日间手术进行。恶心、呕吐和疼痛控制不足是再次就诊或出院失败的最常见原因。加巴喷丁被提倡作为一种辅助手段来减轻这些症状，其在肩关节镜检查中的应用可能提供更好的术后症状控制。本研究的目的是对评估加巴喷丁在肩关节镜检查围手术期管理中作用的研究进行荟萃分析。
加巴喷丁与肩关节镜检查后恶心、呕吐和疼痛控制的显著改善有关。
根据 PRISMA 指南进行了系统的 Medline 检索。符合纳入标准的研究是报告接受任何肩关节镜手术前接受术前加巴喷丁或安慰剂治疗的年龄大于 15 岁的患者的随机对照试验研究。研究根据 CONSORT 清单进行评估。使用 Review Manager 5.3 进行荟萃分析。
确定了四项纳入的随机对照试验（n=227）。荟萃分析表明，加巴喷丁在预防术后恶心方面具有有益的效果（比值比 0.30，p=0.04）。然而，汇总数据分析并未显示使用加巴喷丁在术后疼痛控制方面有显著优势（p=0.11），尽管一项研究表明加巴喷丁后阿片类药物的消耗显著减少。两组之间术后头晕或镇静无显著差异。
加巴喷丁在术后疼痛控制方面没有显示出任何显著的益处，但与肩关节镜检查后恶心和呕吐的显著减少有关。
I，荟萃分析。
