da Silva Fabrício Gomes, Podestá Márcia Helena Miranda Cardoso, Silva Thayná Coelho, de Barros Carlos Marcelo, de Carvalho Breno Fialho Vitarelli, Dos Reis Tiago Marques, Espósito Milena Carla, Marrafon Danielle Aparecida Ferreira de Oliveira, Nogueira Denismar Alves, Diwan Sudhir, Ceron Carla Speroni, Torres Larissa Helena
Department of Food and Drugs, School of Pharmaceutical Sciences, Federal University of Alfenas, Alfenas, Brazil.
Department of Anesthesiology, pain and palliative care, Santa Casa of Alfenas, Alfenas, Brazil.
Clin Exp Pharmacol Physiol. 2023 Mar;50(3):256-263. doi: 10.1111/1440-1681.13742. Epub 2022 Dec 13.
Postoperative pain is one of the main negative symptoms resulting from surgery and the use of new methods to control this symptom is of ever-increasing relevance. Opioid-sparing strategies, such as multimodal analgesia, are trends in this scenario. Pregabalin is a well-established treatment for neuropathic pain; however, it is still controversial in the surgical context for postoperative analgesia. This study investigated the effect of pregabalin on postoperative analgesia in patients undergoing abdominal hysterectomy. It is a prospective, randomised, double-blind, placebo-controlled clinical trial. Female patients undergoing abdominal hysterectomy were randomised to use pregabalin (group P1), 300 mg orally 2 h before surgery, or identical placebo pills (group P0). The main outcome includes the postoperative pain index by visual analogue scale (VAS) and McGill's pain questionnaire. Secondary outcomes include opioid consumption and the presence of adverse effects. A value of p < 0.05 was used to reject type I error. Fifty-five patients were randomised amongst the groups. Patients in group P1 had lower pain rates by VAS scale, both at rest and in active motion, than group P0. In McGill's questionnaire, patients from group P1 also had lower pain rates (12 × 28.5). There was approximately twice as much opioid consumption amongst patients in group P0. Regarding side effects, there was a difference between the two groups only for dizziness, being more incident in group P1. This study suggests that pregabalin is an important adjuvant drug in treating postoperative pain in patients with abdominal hysterectomy.
术后疼痛是手术产生的主要负面症状之一，采用新方法控制这一症状的重要性日益凸显。在这种情况下，诸如多模式镇痛等阿片类药物节省策略成为趋势。普瑞巴林是一种成熟的神经性疼痛治疗药物；然而，在手术背景下用于术后镇痛仍存在争议。本研究调查了普瑞巴林对接受腹部子宫切除术患者术后镇痛的效果。这是一项前瞻性、随机、双盲、安慰剂对照的临床试验。接受腹部子宫切除术的女性患者被随机分为两组，一组使用普瑞巴林（P1组），在手术前2小时口服300毫克，另一组使用相同的安慰剂药丸（P0组）。主要结局指标包括视觉模拟评分法（VAS）的术后疼痛指数和麦吉尔疼痛问卷。次要结局指标包括阿片类药物消耗量和不良反应的发生情况。采用p < 0.05的值来拒绝I型错误。55名患者被随机分组。PⅠ组患者在静息和活动时的VAS疼痛评分均低于P0组。在麦吉尔问卷中，P1组患者的疼痛评分也较低（12×28.5）。P0组患者的阿片类药物消耗量约为P1组的两倍。关于副作用，两组之间仅在头晕方面存在差异，P1组更为常见。本研究表明，普瑞巴林是治疗腹部子宫切除术患者术后疼痛的一种重要辅助药物。
