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不同剂量普瑞巴林预防全身麻醉患者琥珀酰胆碱引发的肌束颤动和肌痛的比较:一项随机对照研究

Comparison of Different Doses of Pregabalin to Prevent Succinylcholine-Initiated Fasciculations and Myalgia in Patients Under General Anesthesia: A Randomised Controlled Study.

作者信息

Sasidharan Malavika, Holyachi Renuka, D Pratibha S

机构信息

Anaesthesiology, Shri B. M. Patil Medical College Hospital and Research Centre, BLDE (Deemed to be University), Vijayapura, IND.

出版信息

Cureus. 2024 Aug 16;16(8):e66985. doi: 10.7759/cureus.66985. eCollection 2024 Aug.

Abstract

Background Succinylcholine (SCh) is the most commonly used muscle relaxant during endotracheal intubation, and it is known to cause fasciculations and postoperative myalgia. Pregabalin is structurally similar to the neurotransmitter gamma-aminobutyric acid (GABA), which is known to reduce SCh-induced fasciculations and myalgia. Materials and methods This study was conducted on patients who underwent surgery under general anesthesia. A total of 201 patients of both genders were assigned to one of the following groups: Group PL (pregabalin low dose) received cap pregabalin 75 mg, Group PH (pregabalin high dose) received cap pregabalin 150 mg, and Group P (placebo) received saccharine pill 10 mg, administered two hours prior to surgery. Results Both the incidence and severity of fasciculations and myalgia were reduced in patients who received pregabalin compared to the placebo group (PH>PL>P). It was observed that as the severity of fasciculations increased, myalgia also increased. The time of the first analgesic dose was longer in the pregabalin group (PH>PL>P). The attenuation of pressor response and hemodynamic stability was greater in the pregabalin group (Group PH>PL>P). Sedation levels were insignificant among groups. The incidence of adverse effects was also insignificant. Conclusion Preoperative prophylactic administration of pregabalin orally in Group PL and PH reduced the incidence and severity of fasciculations and myalgia. Group PH was found to be more effective than PL. Pressor response attenuation was found to be more effective in Group PH.

摘要

背景

琥珀酰胆碱(SCh)是气管插管期间最常用的肌肉松弛剂,已知其会引起肌束颤动和术后肌痛。普瑞巴林在结构上与神经递质γ-氨基丁酸(GABA)相似,已知GABA可减少SCh诱导的肌束颤动和肌痛。

材料与方法

本研究针对接受全身麻醉手术的患者进行。总共201名男女患者被分配到以下组之一:PL组(普瑞巴林低剂量组)接受75毫克胶囊装普瑞巴林,PH组(普瑞巴林高剂量组)接受150毫克胶囊装普瑞巴林,P组(安慰剂组)接受10毫克糖丸,在手术前两小时给药。

结果

与安慰剂组相比,接受普瑞巴林的患者肌束颤动和肌痛的发生率及严重程度均降低(PH>PL>P)。观察到随着肌束颤动严重程度增加,肌痛也增加。普瑞巴林组首次镇痛剂量的时间更长(PH>PL>P)。普瑞巴林组对升压反应的减弱和血流动力学稳定性更好(PH组>PL组>P组)。各组之间的镇静水平无显著差异。不良反应的发生率也无显著差异。

结论

PL组和PH组术前口服预防性给予普瑞巴林可降低肌束颤动和肌痛的发生率及严重程度。发现PH组比PL组更有效。发现PH组对升压反应的减弱更有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb9b/11402504/939a619932d8/cureus-0016-00000066985-i01.jpg

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