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口服普瑞巴林作为全身麻醉联合高位胸段硬膜外麻醉下行冠状动脉旁路移植术患者术后疼痛预防性辅助用药的评估:一项随机对照研究。

Evaluation of Oral Pregabalin as a Preemptive Adjuvant for Postoperative Pain in Patients Undergoing Coronary Artery Bypass Grafting With General Anesthesia and High Thoracic Epidural: A Randomized Controlled Study.

作者信息

Sharma Vipul, Singh Chandipriya

机构信息

Anesthesiology, Dr. D. Y. Patil Medical College, Hospital & Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, IND.

出版信息

Cureus. 2024 Sep 25;16(9):e70142. doi: 10.7759/cureus.70142. eCollection 2024 Sep.

Abstract

Aim This study aimed to evaluate the effectiveness of oral pregabalin as a preventive supplement in managing postoperative pain in patients undergoing coronary artery bypass grafting (CABG) with a combination of general anesthesia and high thoracic epidural anesthesia. Material and methods This 18-month randomized controlled study at a tertiary hospital's anesthesiology department included 62 American Society of Anesthesiologists (ASA) II or III patients aged 35-75 with left ventricular ejection fraction >35%. Placebo (Group B, n = 31) or pregabalin (Group A, n = 31) was randomly allocated. Group A got 150 mg of pregabalin the night before surgery and 75 mg on postoperative days 0 and 1, whereas Group B received a placebo. Postoperative pain was evaluated using the Verbal Numerical Scale and Visual Analogue Scale, while sedation was assessed with the Ramsay Sedation Scale. Statistical analysis was performed using SPSS for Windows, Version 16.0 (Released 2007; SPSS Inc., Chicago). Results In this study, pregabalin significantly reduced postoperative pain on Day 0 and Day 1 (p < 0.001) compared to the placebo. The pregabalin group exhibited higher sedation scores on Day 0 (p < 0.001), but there were no significant differences on Day 1. Inotrope requirements were similar between both groups. Conclusions CABG patients' postoperative pain was greatly reduced by pregabalin without impacting sedation or inotrope needs. These data imply that pregabalin was a useful supplementary analgesic for CABG patients' multimodal pain treatment.

摘要

目的 本研究旨在评估口服普瑞巴林作为预防性补充药物,在全身麻醉联合高位胸段硬膜外麻醉的冠状动脉旁路移植术(CABG)患者中管理术后疼痛的有效性。

材料与方法 这项在一家三级医院麻醉科进行的为期18个月的随机对照研究,纳入了62例年龄在35 - 75岁、美国麻醉医师协会(ASA)分级为II或III级、左心室射血分数>35%的患者。随机分配安慰剂组(B组,n = 31)或普瑞巴林组(A组,n = 31)。A组在手术前一晚服用150 mg普瑞巴林,术后第0天和第1天服用75 mg,而B组接受安慰剂。使用言语数字评分法和视觉模拟评分法评估术后疼痛,同时用拉姆齐镇静评分法评估镇静情况。使用Windows版SPSS 16.0(2007年发布;SPSS公司,芝加哥)进行统计分析。

结果 在本研究中,与安慰剂相比,普瑞巴林在术后第0天和第1天显著减轻了术后疼痛(p < 0.001)。普瑞巴林组在术后第0天的镇静评分更高(p < 0.001),但在第1天无显著差异。两组的血管活性药物需求相似。

结论 普瑞巴林可显著减轻CABG患者的术后疼痛,且不影响镇静或血管活性药物需求。这些数据表明,普瑞巴林是CABG患者多模式疼痛治疗中一种有用的辅助镇痛药。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/16f9/11506319/5784052153b9/cureus-0016-00000070142-i01.jpg

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