Wang Yu-Ting, Xiao Chong, Liu Hong, Fu Xi, Ren Yi-Feng, You Feng-Ming
TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Front Surg. 2021 Oct 18;8:755497. doi: 10.3389/fsurg.2021.755497. eCollection 2021.
To evaluate the efficacy and safety of preoperative oral gabapentin in preventing postoperative Catheter-Related Bladder Discomfort (CRBD) in surgical patients. Randomized controlled trials in which gabapentin was used for the prevention of CRBD in surgical patients with transurethral catheterization were evaluated. The primary outcome was the incidence of moderate-to-severe CRBD at 0, 1, 2, and 6 h after surgery, and secondary outcomes included the incidence of any grade CRBD, postoperative pain, and adverse events. Pooled risk ratios (RRs) and mean difference (MD), 95% confidence intervals (CIs), and values were estimated using fixed and random effects statistical models. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to rate the levels of certainty for key results. A total of 6 randomized controlled trials involving 679 participants were included in the meta-analysis. Gabapentin significantly reduced the risk of moderate-to-severe CRBD at 0, 1, 2, and 6 h (0 h: RR = 0.19, 95% CI: 0.11 to 0.31, < 0.00001; 1 h: RR = 0.40, 95% CI: 0.25 to 0.66, < 0.001; 2 h: RR = 0.38, 95% CI: 0.26 to 0.56, < 0.00001; 6 h: RR = 0.20, 95% CI: 0.11 to 0.38, < 0.00001). The overall incidence of CRBD at 1 h showed no statistical difference between the two groups (RR = 0.55, 95% CI: 0.30 to 1.00, p = 0.05). The risk of CRBD was significantly reduced in the gabapentin group at 0, 2, and 6 h after surgery (0 h: RR = 0.59, 95% CI: 0.46 to 0.74, < 0.0001; 2 h: RR = 0.62, 95% CI: 0.51 to 0.75, < 0.00001; 6 h: RR = 0.66, 95% CI: 0.52 to 0.83, < 0.001). In addition, gabapentin was associated with low postoperative pain intensity without significant side effects. Preoperative oral gabapentin as an adjunct to surgery is effective in decreasing the risk and severity of CRBD over a short time after surgery, and it can decrease postoperative pain without significant side effects. Overall, the level of certainty was moderate to low. https://www.crd.york.ac.uk/prospero/#recordDetails, identifier: CRD42021228171.
评估术前口服加巴喷丁预防手术患者术后导管相关膀胱不适（CRBD）的疗效和安全性。对使用加巴喷丁预防经尿道插管手术患者CRBD的随机对照试验进行评估。主要结局是术后0、1、2和6小时中重度CRBD的发生率，次要结局包括任何级别的CRBD发生率、术后疼痛和不良事件。使用固定效应和随机效应统计模型估计合并风险比（RRs）、平均差（MD）、95%置信区间（CIs）和 值。采用推荐分级评估、制定和评价（GRADE）方法对关键结果的确定性水平进行评级。荟萃分析共纳入6项随机对照试验，涉及679名参与者。加巴喷丁显著降低了术后0、1、2和6小时中重度CRBD的风险（0小时：RR = 0.19，95% CI：0.11至0.31，< 0.00001；1小时：RR = 0.40，95% CI：0.25至0.66，< 0.001；2小时：RR = 0.38，95% CI：0.26至0.56，< 0.00001；6小时：RR = 0.20，95% CI：0.11至0.38，< 0.00001）。1小时时CRBD的总体发生率在两组之间无统计学差异（RR = 0.55，95% CI：0.30至1.00，p = 0.05）。加巴喷丁组在术后0、2和6小时CRBD风险显著降低（0小时：RR = 0.59，95% CI：0.46至0.74，< 0.0001；2小时：RR = 0.62，95% CI：0.51至0.75，< 0.00001；6小时：RR = 0.66，95% CI：0.52至0.83，< 0.0
