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普瑞巴林对择期剖宫产患者硬膜外穿刺后头痛的影响:一项随机对照试验。

The effect of pregabalin on postdural puncture headache among patients undergoing elective cesarean section: A randomized controlled trial.

作者信息

Karami Tohid, Hoshyar Hadi, Jafari Amin Farid

机构信息

Department of Anesthesiology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran.

出版信息

Ann Med Surg (Lond). 2021 Mar 17;64:102226. doi: 10.1016/j.amsu.2021.102226. eCollection 2021 Apr.

Abstract

INTRODUCTION

Post-dural puncture headache (PDPH) is one of the most common problems of cesarean section. The present study aimed to evaluate the effect of pregabalin on PDPH among patients undergoing elective cesarean section.

MATERIALS AND METHODS

This double-blind clinical trial was performed on 136 patients undergoing elective cesarean section referred to Shahid Motahari Teaching Hospital in Urmia in northwestern Iran from February 1 to December 20, 2020. Patients were selected by convenience sampling method and randomly divided into two groups of intervention and control (N = 68 people each group). The presence of PDPH and its severity were recorded in the checklist based on the VAS, and conventional treatments were prescribed in the case of occurrence of the PDPH. The PDPH severity was also assessed by the patient using the 10-cm Visual Analog Scale (VAS).

RESULTS

The mean age of participants was 27.82 years. A total of 29 people suffered from hypotension. Regarding pain severity, the mean pain score in the intervention group was significantly lower than the control group (p = 0.01). Results also showed that the frequency of PDPH in the intervention group was significantly lower than the placebo group (4.4% vs. 11.8%; p = 0.019). There was no significant difference between intervention and control groups in terms of demographic characteristics (p > 0.05).

CONCLUSION

Results of the present study showed the use of oral pregabalin at night before spinal anesthesia in patients undergoing elective cesarean(C-) section had a preventive effect on the severity and incidence of PDPH.

摘要

引言

硬膜穿刺后头痛(PDPH)是剖宫产最常见的问题之一。本研究旨在评估普瑞巴林对择期剖宫产患者PDPH的影响。

材料与方法

本双盲临床试验于2020年2月1日至12月20日对转诊至伊朗西北部乌尔米亚的沙希德·莫塔哈里教学医院的136例择期剖宫产患者进行。患者采用便利抽样法选取,并随机分为干预组和对照组(每组N = 68人)。根据视觉模拟评分法(VAS)在检查表中记录PDPH的存在及其严重程度,若发生PDPH则给予常规治疗。患者也使用10厘米视觉模拟量表(VAS)评估PDPH严重程度。

结果

参与者的平均年龄为27.82岁。共有29人出现低血压。关于疼痛严重程度,干预组的平均疼痛评分显著低于对照组(p = 0.01)。结果还显示,干预组PDPH的发生率显著低于安慰剂组(4.4%对11.8%;p = 0.019)。干预组和对照组在人口统计学特征方面无显著差异(p>0.05)。

结论

本研究结果表明,择期剖宫产患者在脊髓麻醉前一晚口服普瑞巴林对PDPH的严重程度和发生率有预防作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a737/8022150/1323e5e247d8/gr1.jpg

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