Adegboye K Adewale, Kolawole I K, Bolaji B O, Suleiman Z A, Adegboye M B
Department of Anaesthesia, University of Ilorin Teaching Hospital, Ilorin, Kwara State, Nigeria.
J West Afr Coll Surg. 2022 Jul-Sep;12(3):1-7. doi: 10.4103/jwas.jwas_802_22. Epub 2022 Oct 6.
Post-operative pain treatment is a major challenge in our environment. Opioids may cause respiratory depression post-operatively. Therefore, any combination of opioid and non-opioid analgesics that provides quality post-operative pain control and reduces opioid consumption with its attendant side effects will be highly desirable.
The aim of this article is to evaluate analgesic benefits and opioid-sparing effects of pre-operative oral pregabalin in patients who undergo abdominal gynaecological surgeries.
A prospective randomized double-blind placebo-controlled study is carried out at University of Ilorin Teaching Hospital, Kwara State, Nigeria. Eighty-two patients scheduled for gynaecological surgeries were randomized into two equal groups. The patients in the control and study groups received a placebo drug and oral pregabalin 150 mg, respectively, 1 h before induction of general anaesthesia. Post-operative pain intensity using a five-point Verbal Rating Scale, time to first request for analgesia, and 24 h post-operative pethidine consumptions were assessed. Mean values were compared using Student's test. Categorical data were compared with the test. Level of significance was set at 5% (0.05) and power of the study was 80%.
Demographic characteristics were comparable between the two groups. The median pain score was 0-2 (no pain-moderate pain) throughout the study. Post-operative static and dynamic pain scores at 1, 4, and 12 h were significantly higher in the placebo group (<0.001). Twenty-four hours post-operatively, there were no significant differences in static and dynamic pain scores between the two groups (=0.131 and =0.384, respectively). Time to first analgesic requirement and total pethidine consumed within 24 h post-operative were 47 ± 19 vs. 258 ± 137 min (=0.001) and 326.19 ± 62.70 vs. 192.86 ± 55.84 mg (=0.001) in the control and study groups, respectively. The pre-operative use of pregabalin reduced post-operative opioid requirement by 40.9% in the study group. Nausea and vomiting were more common in the placebo group, whereas dizziness, blurring of vision, and sedation were more common in the pregabalin group.
A single pre-operative dose of 150 mg oral pregabalin had significantly greater analgesic effects compared with placebo and reduced post-operative opioid requirements in patients undergoing myomectomy or total abdominal hysterectomy. It should be considered an adjuvant in multimodal pain management regimens following gynaecological surgeries.
在我们所处的环境中，术后疼痛治疗是一项重大挑战。阿片类药物术后可能会导致呼吸抑制。因此，任何能提供优质术后疼痛控制、减少阿片类药物用量及其伴随副作用的阿片类与非阿片类镇痛药组合都将非常理想。
本文旨在评估术前口服普瑞巴林对接受腹部妇科手术患者的镇痛效果及阿片类药物节省效应。
在尼日利亚夸拉州伊洛林大学教学医院开展了一项前瞻性随机双盲安慰剂对照研究。82例计划进行妇科手术的患者被随机分为两组。对照组和研究组患者分别在全身麻醉诱导前1小时接受安慰剂药物和150毫克口服普瑞巴林。使用五点语言评定量表评估术后疼痛强度、首次要求镇痛的时间以及术后24小时哌替啶用量。采用学生检验比较均值。分类数据采用卡方检验进行比较。显著性水平设定为5%（0.05），研究效能为80%。
两组患者的人口统计学特征具有可比性。在整个研究过程中，疼痛评分中位数为0至2（无痛至中度疼痛）。安慰剂组术后1小时、4小时和12小时的静态和动态疼痛评分显著更高（<0.001）。术后24小时，两组之间的静态和动态疼痛评分无显著差异（分别为=0.131和=0.384）。对照组和研究组术后首次镇痛需求时间及术后24小时内哌替啶总用量分别为47±19分钟对258±137分钟（=0.001）和326.19±62.70毫克对192.86±55.84毫克（=0.001）。研究组术前使用普瑞巴林使术后阿片类药物需求量降低了40.9%。安慰剂组恶心和呕吐更为常见，而普瑞巴林组头晕、视力模糊和镇静更为常见。
与安慰剂相比，术前单次口服150毫克普瑞巴林对接受子宫肌瘤切除术或全腹子宫切除术的患者具有显著更强的镇痛效果，并降低了术后阿片类药物需求量。在妇科手术后的多模式疼痛管理方案中，应将其视为一种辅助药物。
