Sarridou D G, Boutou A K, Konstantinidou M, Cox F, Argiriadou H, Walker C P
Department of Anaesthesia and Intensive Care, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Department of Respiratory Medicine, Hippokratio General Hospital, Thessaloniki, Greece.
Hippokratia. 2023 Jan-Mar;27(1):22-24.
End-stage respiratory failure is non-treatable with mechanical ventilation and can be treated with veno-venous extracorporeal membrane oxygenators (VV-ECMO). It can also be used as a bridge to lung transplantation or recovery of lung function. This patient group can suffer from chronic pain, which is further exacerbated by painful procedures required as part of treatment. Pregabalin is licensed for chronic neuropathic pain and generalized anxiety disorder. Thus far, it has not been tried in routine analgesia protocols for pain relief of patients on VV-ECMO.
We included nine patients aged 17-54 years on VV-ECMO awaiting lung transplantation. Exclusion criteria were acute kidney injury and chronic kidney disease. All patients had morphine patient-control analgesia. In addition, pregabalin 50 mg twice daily was initiated in all patients with dose escalation as required. Pain scores and quality of sleep were evaluated daily. All patients experienced significant pain relief, demonstrated by reduced pain scores after treatment commencement. The mean visual analogue scale score was reduced significantly from 6 ± 2 to 3 ± 1. A significant increase in good-quality sleep duration was recorded from 5 ± 1.7 hours per day before to 8 ± 2.1 hours per day after pregabalin treatment. All patients except for two reported reduced anxiety levels of at least 2 ± 1 scale improvement (p <0.05).
Pregabalin is an efficient analgesic with accompanying anxiolytic effects in this group of patients with unique characteristics such as high analgesia requirements and exacerbated psychological and emotional stress. HIPPOKRATIA 2023, 27 (1):22-24.
终末期呼吸衰竭无法通过机械通气治疗，可采用静脉 - 静脉体外膜肺氧合（VV - ECMO）进行治疗。它还可作为肺移植或肺功能恢复的桥梁。该患者群体可能患有慢性疼痛，而治疗过程中所需的痛苦操作会进一步加剧这种疼痛。普瑞巴林被批准用于治疗慢性神经性疼痛和广泛性焦虑症。迄今为止，尚未在VV - ECMO患者的常规镇痛方案中尝试使用它来缓解疼痛。
我们纳入了9名年龄在17 - 54岁、正在接受VV - ECMO治疗并等待肺移植的患者。排除标准为急性肾损伤和慢性肾病。所有患者均采用吗啡患者自控镇痛。此外，所有患者均开始每日两次服用50 mg普瑞巴林，并根据需要增加剂量。每天评估疼痛评分和睡眠质量。所有患者的疼痛均得到显著缓解，治疗开始后疼痛评分降低即表明了这一点。视觉模拟量表评分的平均值从6±2显著降低至3±1。优质睡眠时间从普瑞巴林治疗前每天5±1.7小时显著增加至治疗后每天8±2.1小时。除两名患者外，所有患者报告焦虑水平至少改善了2±1分（p<0.05）。
在这类具有高镇痛需求以及心理和情绪压力加剧等独特特征的患者中，普瑞巴林是一种有效的镇痛药，同时具有抗焦虑作用。《希波克拉底》2023年，第27卷（1）：22 - 24页。
