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口服普瑞巴林与静脉注射氯胺酮对减轻腹式子宫切除术后急性疼痛效果的比较:一项随机双盲临床试验。

Comparison of the effect of oral pregabalin with intravenous ketamine on reducing acute pain after abdominal hysterectomy: A randomized double-blind clinical trial.

作者信息

Ghadami Negin, Sarshivi Farzad, Barzanji Arvin, Nouri Bijan, Mohammadi Zahra

机构信息

Department of Anesthesiology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran.

Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran.

出版信息

Caspian J Intern Med. 2021 Mar;12(2):217-222. doi: 10.22088/cjim.12.2.217.

DOI:10.22088/cjim.12.2.217
PMID:34012541
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8111811/
Abstract

BACKGROUND

The aim of this study was to compare the analgesic effects of pregabalin and ketamine on reducing pain after abdominal hysterectomy.

METHODS

In this double-blind clinical trial, one hundred forty ASA I and II patients of age range 30-60 years scheduled for abdominal hysterectomy undergoing general anesthesia in 2018, were randomly divided into 4 equal groups. Pregabalin group received 300 mg oral pregabalin, ketamine group received 0.3 mg/kg of intravenous ketamine, and pregabalin- ketamine group received the combination of the two-above medication, and placebo group received the placebo and saline. Patients were evaluated for pain intensity according to the visual analogue scale (VAS) at 2, 4, 6, 12, 18, and 24 hours after surgery. Also, the need for analgesic drugs and the frequency of repetitions were also recorded. Statistical analysis was performed using STATA, Version 14. A p- value less than 0.05 was considered statistically significant.

RESULTS

In the pregabalin and pregabalin-ketamine groups, pain in the first 6 hours after the end of operation was significantly less than the other two groups (p<0.05), but there was no significant difference between the 4 groups at 18 and 24 hours after surgery. The need for analgesic medications in the pregabalin group was lower than in other groups (p<0.05).

CONCLUSION

The results of this study show that the administration of oral pregabalin with and without intravenous ketamine before abdominal hysterectomy can decrease postoperative pain and reduce the need for analgesia.

摘要

背景

本研究的目的是比较普瑞巴林和氯胺酮在减轻腹部子宫切除术后疼痛方面的镇痛效果。

方法

在这项双盲临床试验中,2018年计划接受腹部子宫切除术并接受全身麻醉的140例年龄在30至60岁之间的ASA I级和II级患者被随机分为4组,每组人数相等。普瑞巴林组口服300毫克普瑞巴林,氯胺酮组静脉注射0.3毫克/千克氯胺酮,普瑞巴林 - 氯胺酮组接受上述两种药物的联合使用,安慰剂组接受安慰剂和生理盐水。在术后2、4、6、12、18和24小时,根据视觉模拟量表(VAS)对患者的疼痛强度进行评估。此外,还记录了镇痛药物的需求和重复使用频率。使用STATA 14版进行统计分析。p值小于0.05被认为具有统计学意义。

结果

在普瑞巴林组和普瑞巴林 - 氯胺酮组中,术后前6小时的疼痛明显低于其他两组(p<0.05),但术后18和24小时,4组之间无显著差异。普瑞巴林组对镇痛药物的需求低于其他组(p<0.05)。

结论

本研究结果表明,腹部子宫切除术前口服普瑞巴林联合或不联合静脉注射氯胺酮均可减轻术后疼痛并减少镇痛需求。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f736/8111811/260fec2b7ea0/cjim-12-217-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f736/8111811/ccbe6623d782/cjim-12-217-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f736/8111811/0c03be7eabca/cjim-12-217-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f736/8111811/260fec2b7ea0/cjim-12-217-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f736/8111811/ccbe6623d782/cjim-12-217-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f736/8111811/0c03be7eabca/cjim-12-217-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f736/8111811/260fec2b7ea0/cjim-12-217-g003.jpg

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本文引用的文献

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Saudi J Anaesth. 2015 Jul-Sep;9(3):253-7. doi: 10.4103/1658-354X.154697.
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Effects of adding ketamine to fentanyl plus acetaminophen on postoperative pain by patient controlled analgesia in abdominal surgery.腹部手术中,将氯胺酮添加到芬太尼加对乙酰氨基酚中通过患者自控镇痛对术后疼痛的影响。
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静脉注射对乙酰氨基酚优于氯胺酮用于腹部子宫切除术后的术后疼痛:一项前瞻性、随机、双盲、多中心临床试验的结果。
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