普瑞巴林与加巴喷丁用于腹式子宫切除术后疼痛治疗的效果比较

目的:比较术前2h应用普瑞巴林与加巴喷丁对腹式子宫切除术后疼痛治疗的效果及安全性。方法:90例ASAⅠ、Ⅱ级全麻下行腹式子宫切除术的妇女中行随机、安慰剂对照研究。术前2h给予病人300mg普瑞巴林(P组)、900mg加巴喷丁(G组)及安慰剂(C组),每组30例。术后4h常规静注氟比洛芬酯100mg镇痛,当静息视觉模拟评分(VAS)>3时实施曲马多补救镇痛。记录术后24h各时点静息及咳嗽VAS评分、镇静评分,记录术后24h内曲马多使用次数、用量及相关副作用,行术后患者总体满意度评价。结果:P组及G组麻醉后苏醒时间明显长于C组(P<0.05)。P组术后1、2h静息VAS评分,术后1、2、4h咳嗽VAS评分均低于C组及G组(P<0.05)。G组术后1、2、6h镇静评分明显高于C组,P组术后1、2h镇静评分明显高于C组(P<0.05)。P组与G组术后首次镇痛时间明显长于C组(P<0.05),曲马多补救镇痛人数明显少于C组,且P组少于G组(P<0.05),曲马多剂量也明显低于C组(P<0.05)。三组患者术后24h头晕的发生率相似(P>0.05),但G组患者术后嗜睡的发生率明显高于P组及C组(P<0.05)。P组及G组患者术后24h总体满意度评价"非常好"的百分率明显高于C组,P组高于G组(P<0.05)。结论:行腹式子宫切除术前2h口服给予普瑞巴林300mg,与给予900mg加巴喷丁和安慰剂相比,术后镇痛药物的需求量显著减少,患者总体满意度更高。

Comparison of pregabalin and gabapentin on analgesic efficacy in patients after abdominal hysterectomy

AIM: To investigate the analgesic efficacy and safety of pregabalin in patients after abdominal hysterectomy and compare with gabapentin.METHODS: A randomized,placebo-controlled study was conducted in 90 women undergoing abdominal hysterectomy who were anaesthetized in a standardized fashion.Patients received 300 mg pregabalin(Group P),900 mg gabapentin(Group G) or placebo(Group C),2 h prior to surgery,n=30 in each group.100 mg flubiprofen axetil was intravenous infused at 4 h postoperation for conventional analgesia,rescue analgesia was administered at visual analog scales(VAS) scores >3 with intravenous tramadol.VAS scores at resting or coughing and sedation scores were recorded at arrived PACU,1,2,4,6,8,12,18 and 24 h postoperation.The frequency and dosage of tramadol,incidence of adverse effects within 24 h postoperation were noted.The patients global satisfacation of postoperative analgesia was evaluated at 24 h postoperation.RESULTS:Recovery time from anesthesia was significantly longer in group P and G than that in group C(P<0.05).Resting VAS scores in 1,2 h and coughing VAS scores in 1,2 4 h postoperation were lower in group P than those in group C and G(P<0.05).Sedation scores in 1,2,6 h postoperation was significantly higher in group G than that in group C,and in 1,2 h postoperation were significantly higher in gourp P than those in gorup C(P<0.05).Time of patient’s first request for analgesic was significantly longer in group P and G than that in group C(P<0.05).The number of tramadol rescue analgesia and dosage of tramadol were significantly less in group P and G than those in group C(P<0.05),and was significantly less in gorup P than that in group G(P<0.05).There was no significantly difference in incidence of dizziness in three groups,but the incidence of somnolence was significantly higher in group G than those in group C and P(P<0.05).The rate of patients,global satisfacation of postoperative analgesia which in "excellent" was significantly better in group P and G than that in group C(P<0.05),and also better in gorup P than that in group G(P<0.05).CONCLUSION: Pregabalin 300 mg given orally 2 h before abdominal hysterectomy can result in significantly reduced postoperative analgesic requirement and better patients global satisfacation compare with gabapentin 900 mg and placebo.