术前普瑞巴林预防琥珀酰胆碱引起的肌束颤动和肌痛：一项随机试验的荟萃分析。

Preoperative pregabalin prevents succinylcholine-induced fasciculation and myalgia: A meta-analysis of randomized trials.

机构信息

Department of Anesthesiology, Universidad del Valle, Cali, Colombia.

Anesthesiology Research Department, Mass Eye & Ear Institute, Harvard Medical School, Boston, MA, USA.

出版信息

Rev Esp Anestesiol Reanim (Engl Ed). 2024 Apr;71(4):324-331. doi: 10.1016/j.redare.2022.12.002. Epub 2023 Sep 4.

DOI:10.1016/j.redare.2022.12.002

PMID:37673208

Abstract

Succinylcholine is the gold standard neuromuscular blocker for rapid sequence induction; however, its use is associated with fasciculation and myalgia. We performed a systematic review and meta-analysis of randomized controlled clinical trials comparing gabapentinoids versus placebo for the prevention of fasciculations and succinylcholine-induced myalgias. Six randomized clinical studies were included with a total of 481 patients - 241 in the intervention group and 240 in the placebo group. Gabapentinoids reduced the incidence of succinylcholine-induced myalgia (RR=0.69, 95% CI 0.56-0.84, P<.001), which remained statistically significant for pregabalin (RR=0.71, 95% CI 0.54-0.93, P=.013) and gabapentin (RR=0.61, 95% CI 0.45-0.82, P=.001) separately. There was no difference in fasciculations between the groups (RR=0.92, 95% CI 0.82-1.03, P=.148). Preoperative use of gabapentinoids is associated with lower incidence of succinylcholine-induced myalgias within the first 24h of surgery.

摘要

琥珀酰胆碱是快速序贯诱导的金标准神经肌肉阻滞剂；然而，其使用与束颤和肌痛有关。我们对比较加巴喷丁类药物与安慰剂预防束颤和琥珀酰胆碱诱导的肌痛的随机对照临床试验进行了系统评价和荟萃分析。共纳入了 6 项随机临床试验，共有 481 名患者参与，干预组 241 名，安慰剂组 240 名。加巴喷丁类药物降低了琥珀酰胆碱诱导的肌痛发生率（RR=0.69，95%CI 0.56-0.84，P<.001），这在普瑞巴林（RR=0.71，95%CI 0.54-0.93，P=.013）和加巴喷丁（RR=0.61，95%CI 0.45-0.82，P=.001）中仍然具有统计学意义。两组之间的束颤无差异（RR=0.92，95%CI 0.82-1.03，P=.148）。术前使用加巴喷丁类药物与术后 24 小时内琥珀酰胆碱诱导的肌痛发生率降低有关。