Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610072, China.
Medicina (Kaunas). 2023 Jan 31;59(2):280. doi: 10.3390/medicina59020280.
: As an adjunct to postoperative multimodal analgesic regimens, pregabalin has been reported in reducing postoperative acute pain and opioid consumption. However, there is only a small amount of evidence for preemptive pregabalin in patients undergoing cancer-related surgery. This systematic review was conducted to integrate high-quality evidence to evaluate the preemptive analgesic effects of pregabalin in cancer-related surgery. : Seven electronic databases were searched in a combination of subject terms and free words. Efficacy and safety of preemptive pregabalin on postoperative pain for cancer-related surgery were evaluated by assessing resting and dynamic pain scores postoperatively, cumulative morphine equivalent consumption, time to first analgesic request, hemodynamic parameters, and the safety indicators. : Thirteen trials were incorporated for quantitative synthesis. The pooled results showed administration of pregabalin preoperatively is clinically significant for improving resting (weighted mean difference (WMD), -1.53 cm; 95% CI, -2.30 to -0.77) and dynamic (WMD, -1.16 cm; 95% CI, -2.22 to -0.11) pain severity scores at 2 h postoperatively and prolonging time to first analgesic request (WMD, 2.28 h; 95% CI, 0.79 to 3.77) in cancer-related surgery. Preemptive pregabalin was also statistically effective in some other pain indicators but would increase the risk of pregabalin-related side effects after surgery. : Our findings do not support the administration of pregabalin in doses larger than 300 mg when put in cancer-related surgery. Taken together, more high-quality research particularly focused on the optimal dosages and timing of pregabalin in cancer-related surgery is needed in the future to establish stronger evidence for therapeutic effects.
: 作为术后多模式镇痛方案的辅助手段，普瑞巴林已被报道可减轻术后急性疼痛和阿片类药物的消耗。然而，只有少量证据表明普瑞巴林在接受与癌症相关的手术的患者中具有预先镇痛作用。本系统评价旨在整合高质量证据，评估普瑞巴林在与癌症相关的手术中的预先镇痛作用。 : 我们以主题词和自由词相结合的方式对 7 个电子数据库进行了检索。通过评估术后静息和动态疼痛评分、累积吗啡等效消耗量、首次镇痛请求时间、血流动力学参数和安全性指标，评估预先给予普瑞巴林对与癌症相关的手术术后疼痛的疗效和安全性。 : 纳入了 13 项试验进行定量综合分析。汇总结果显示，术前给予普瑞巴林在改善术后 2 小时静息（加权均数差（WMD），-1.53cm；95%CI，-2.30 至-0.77）和动态（WMD，-1.16cm；95%CI，-2.22 至-0.11）疼痛严重程度评分以及延长首次镇痛请求时间（WMD，2.28h；95%CI，0.79 至 3.77）方面具有临床意义。预先给予普瑞巴林在一些其他疼痛指标上也具有统计学意义，但会增加术后与普瑞巴林相关的副作用风险。 : 我们的研究结果不支持在与癌症相关的手术中给予超过 300mg 剂量的普瑞巴林。综上所述，未来需要更多高质量的研究，特别是关注普瑞巴林在与癌症相关的手术中的最佳剂量和时间，以建立更强有力的治疗效果证据。
