Amiri Hamid Reza, Ohadian Moghadam Solmaz, Momeni Seyed Ali, Amini Majid
Uro-Oncology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Department of Anesthesiology and Critical Care, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
Anesth Pain Med. 2020 Sep 28;10(5):e100718. doi: 10.5812/aapm.100718. eCollection 2020 Oct.
Postoperative pain management can improve patients' quality of life and decrease hospitalization rates. Preemptive analgesia may provide an effective approach for both pain control and opioid consumption decrease. A common approach for pain management after surgery is to relieve the pain that has already occurred.
The aim of this clinical trial was to compare the preemptive analgesic effect of single-dose versus two-dose administration of pregabalin, acetaminophen, naproxen, and dextromethorphan (PAND) combination.
This study involved 60 patients who had undergone one surgery (including nephrectomy, cystectomy, prostatectomy, colectomy, Whipple, and RPLND). They were randomly divided into two groups: The first group received a single dose of PAND, while the other group received a second dose within 6 hours after discharge from recovery. Pain intensity was assessed by the Universal Pain Assessment Tool (UPAT) in both groups 2, 4, 6, 8, 12, 24, and 48 hours postoperatively. The postoperative morphine dose in both groups was also recorded. Data were analyzed using SPSS version 25.
Mean pain scores were significantly different between the two groups at 2, 12, 24, and 48 hours after surgery (P < 0.05). There was a statistically significant difference between the two groups in terms of opioid consumption (P < 0.001). The total opioid consumption in the second group (with the second administration of PAND) was lower than the first group.
Preemptive analgesia with a second dose of PAND is an effective method for reducing pain and morphine consumption after surgery.
术后疼痛管理可改善患者生活质量并降低住院率。超前镇痛可能为控制疼痛和减少阿片类药物用量提供一种有效方法。术后疼痛管理的常见方法是缓解已经出现的疼痛。
本临床试验的目的是比较加巴喷丁、对乙酰氨基酚、萘普生和右美沙芬（PAND）联合用药单剂量与两剂量给药的超前镇痛效果。
本研究纳入60例接受过一种手术（包括肾切除术、膀胱切除术、前列腺切除术、结肠切除术、惠普尔手术和腹膜后淋巴结清扫术）的患者。他们被随机分为两组：第一组接受单剂量PAND，而另一组在从恢复室出院后6小时内接受第二剂。两组在术后2、4、6、8、12、24和48小时使用通用疼痛评估工具（UPAT）评估疼痛强度。还记录了两组术后吗啡用量。使用SPSS 25版分析数据。
两组在术后2、12、24和48小时的平均疼痛评分有显著差异（P<0.05）。两组在阿片类药物用量方面有统计学显著差异（P<0.001）。第二组（接受第二剂PAND）的阿片类药物总用量低于第一组。
第二剂PAND超前镇痛是一种降低术后疼痛和吗啡用量的有效方法。
