Salarian Sara, Memary Elham, Taheri Farinaz, Bagheri Bahador
Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Cancer Research Center, Semnan University of Medical Sciences, Semnan, Iran; Center for Molecular Cardiology, University of Zurich, Schlieren, Switzerland.
Turk J Anaesthesiol Reanim. 2022 Apr;50(2):101-106. doi: 10.5152/TJAR.2022.21366.
Fentanyl and midazolam are popular drugs for sedation and analgesia in intensive care unit. Gabapentin has sedative and analgesic effects, as well. Our purpose was to study gabapentin addition to fentanyl and midazolam to reach the target sedation level in patients requiring mechanical ventilation.
This was a randomized and double-blinded trial. Fifty patients receiving mechanical ventilation and aged from 18 to 70 years were randomized 1 : 1 to 300 mg gabapentin q8hr or placebo. The initial infusion rates of fentanyl and midazolam were 1-2 µg kg-1 h-1 and 0.06-0.2 mg kg-1 h-1, respectively, in both groups. Treatments continued prior to weaning. Ramsay sedation scale score (2-3) and behavioral pain scale score (≤4) were used for the evaluation of sedation and analgesia levels, respectively.
A total of 43 patients were studied. Both treatment modalities reached the target sedation and analgesia levels. In the intervention group, there were significant reductions in daily consumption of fentanyl and midazolam (P < .01). Duration of ventilation was shorter in the intervention group (4.1 ± 1.7 days vs 5.1 ± 1.3 days, P > .05). There was no significant difference in intensive care hospitalization, although it was shorter in the intervention group (201 ± 24 hours vs 224 ± 19 hours, P > .05).
This trail showed that both treatment modalities could reach target sedation and analgesia levels without significant differences. Add-on therapy with gabapentin could reduce the total dose of fentanyl and midazolam.
芬太尼和咪达唑仑是重症监护病房常用的镇静和镇痛药物。加巴喷丁也具有镇静和镇痛作用。我们的目的是研究在芬太尼和咪达唑仑基础上加用加巴喷丁，以使需要机械通气的患者达到目标镇静水平。
这是一项随机双盲试验。50例年龄在18至70岁之间接受机械通气的患者按1:1随机分为每8小时口服300 mg加巴喷丁组或安慰剂组。两组中芬太尼和咪达唑仑的初始输注速率分别为1-2 μg·kg-1·h-1和0.06-0.2 mg·kg-1·h-1。在撤机前持续进行治疗。分别采用Ramsay镇静评分（2-3分）和行为疼痛评分（≤4分）评估镇静和镇痛水平。
共研究了43例患者。两种治疗方式均达到了目标镇静和镇痛水平。干预组中，芬太尼和咪达唑仑的每日消耗量显著降低（P <.01）。干预组的通气时间较短（4.1±1.7天 vs 5.1±1.3天，P>.05）。重症监护病房住院时间虽干预组较短（201±24小时 vs 224±19小时，P>.05），但差异无统计学意义。
本试验表明两种治疗方式均可达到目标镇静和镇痛水平，且无显著差异。加用加巴喷丁治疗可减少芬太尼和咪达唑仑的总剂量。
