Baloch Shahzaib R, Hashmi Imtiaz A, Rafi Mohammad S, Wasim Ambreen, Mazar Saddam, Malick Nadia, Tayyab Banin, Riaz Hoordana
Orthopaedics, Dr. Ziauddin Hospital, Karachi, PAK.
Orthopedics/ Consultant Spine and Orthopedics Surgeon, Agha Khan University Hospital, Karachi, Karachi, PAK.
Cureus. 2021 Jan 22;13(1):e12870. doi: 10.7759/cureus.12870.
Purpose The purpose of this study is to compare the effect of pregabalin in reducing the neuropathic pain in postoperative patients who have undergone single-level microdiscectomy for prolapsed intervertebral lumbar disc. Methods A randomized control clinical trial was conducted from June 2018 to April 2020 in three campuses Dr. Ziauddin University Hospital, Karachi, by two spinal surgeons. This study included 84 patients who underwent either emergency or elective microdiscectomy surgery. The patients randomized into two equal groups of 42, (group-A: pregabalin) and (group-B: placebo). Both groups also received routine analgesia along with the pregabalin and placebo capsules. In the intervention group, pregabalin was administered preoperative and postoperative defined times. The pain scores were recorded by visual analog scale (VAS) and Roland-Morris score system on the preoperative day and compared to the scores on follow-up on postoperative day seven. Results The pain scores were significantly better in group-A compared to group-B with similar baseline variables. The mean VAS scores of pains in group-A on postoperative day seven on follow-up were compared to VAS pain scores in group-B showing better pain control. The Roland-Morris scores were also significantly better for group-A. Conclusions The use of pregabalin in addition to the routine analgesia has better control of postoperative neuropathic pain in patients with single-level microdiscectomy compared to the patients who are receiving only routine analgesia. Other factors like cost, dose, side effects, and frequency should also be considered.
目的 本研究的目的是比较普瑞巴林对接受单节段腰椎间盘突出症显微椎间盘切除术的术后患者减轻神经性疼痛的效果。方法 2018年6月至2020年4月，在卡拉奇齐亚丁大学医院的三个院区，由两位脊柱外科医生进行了一项随机对照临床试验。本研究纳入了84例行急诊或择期显微椎间盘切除术的患者。患者被随机分为两组，每组42人，（A组：普瑞巴林）和（B组：安慰剂）。两组患者在服用普瑞巴林和安慰剂胶囊的同时还接受常规镇痛治疗。在干预组中，在术前和术后规定时间给予普瑞巴林。在术前一天通过视觉模拟量表（VAS）和罗兰-莫里斯评分系统记录疼痛评分，并与术后第七天随访时的评分进行比较。结果 在基线变量相似的情况下，A组的疼痛评分明显优于B组。随访时A组术后第七天的平均VAS疼痛评分与B组的VAS疼痛评分相比，显示出更好的疼痛控制效果。A组的罗兰-莫里斯评分也明显更好。结论 与仅接受常规镇痛的患者相比，在常规镇痛基础上加用普瑞巴林对单节段显微椎间盘切除术患者的术后神经性疼痛有更好的控制效果。还应考虑其他因素，如成本、剂量、副作用和用药频率等。
