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阿片类药物节省麻醉:加巴喷丁与术后疼痛。

Opioid-Sparing Anesthesia: Gabapentin and Postoperative Pain.

机构信息

Department of Anesthesiology, Paso Del Norte Surgical Center, El Paso, TX.

Department of Anesthesiology, Los Angelas County Medical Center, Keck School of Medicine, University of Southern California, Los Angelas, CA.

出版信息

J Perianesth Nurs. 2022 Dec;37(6):966-970. doi: 10.1016/j.jopan.2022.04.008. Epub 2022 Sep 11.

Abstract

PURPOSE

Nonopioid analgesics are commonly used to augment or replace opioids in the perioperative setting. Perianesthesia nurses must consider timing and appropriateness when administering these medications to patients in the preoperative area or the postanesthesia care unit, particularly when other medications with sedative effects are being given. Gabapentin, originally proposed as an anticonvulsant medication, promotes analgesia and reduces risk for postoperative nausea and vomiting. This review examines the effect of gabapentin on postoperative pain.

DESIGN

A systematic review.

METHODS

CINAHL, PubMed, and Cochrane Review databases were searched to find a total of 93 sources that examined gabapentin and postoperative pain. After applying inclusion and exclusion criteria, four randomized controlled trials (RCT) were reviewed. Postoperative pain within the 24 hours of surgery was measured as the primary outcome using the visual analog scale in all sources FINDINGS: Three of the four reviewed RCTs determined gabapentin was both statistically and clinically significant in reducing postoperative pain, and all four sources showed a reduction in opioid consumption during the immediate postoperative period, which promoted patient satisfaction.

CONCLUSIONS

Further study of gabapentin and postoperative pain is needed employing rigorous and robust methodology and diversity of the sample selections.

摘要

目的

非阿片类镇痛药常用于围手术期增强或替代阿片类药物。麻醉护士必须考虑在术前区域或麻醉后护理单元给患者使用这些药物的时间和适当性,特别是当给予其他具有镇静作用的药物时。加巴喷丁最初被提议作为一种抗惊厥药物,可促进镇痛并降低术后恶心和呕吐的风险。本综述研究了加巴喷丁对术后疼痛的影响。

设计

系统综述。

方法

检索 CINAHL、PubMed 和 Cochrane Review 数据库,共找到 93 个研究加巴喷丁和术后疼痛的来源。在应用纳入和排除标准后,对四项随机对照试验 (RCT) 进行了回顾。所有来源均使用视觉模拟量表测量术后 24 小时内的术后疼痛,作为主要结局指标。

结果

四项综述的 RCT 中有三项确定加巴喷丁在减轻术后疼痛方面具有统计学和临床意义,所有四项来源均显示术后即刻阿片类药物消耗减少,从而提高了患者满意度。

结论

需要采用严格和稳健的方法以及样本选择的多样性,进一步研究加巴喷丁和术后疼痛。

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