加巴喷丁和可乐定对子宫全切术患者术后焦虑、疼痛的影响

Effect of Gabapentin and Clonidine on Postoperative Anxiety and Pain in Patients Undergoing Abdominal Hysterectomy

【目的】探讨加巴喷丁和可乐定对子宫全切术患者术后焦虑和疼痛的影响。【方法】60例ASAⅠ～Ⅱ级的择期妇科手术病人，随机分为3组，每组20例。G组：手术前夜和术前2h和术后24h口服加巴喷丁1200mg；C组：手术前夜和术前2h以及术后24h口服可乐定100μg；P组：口服安慰剂。手术前夜以及术后2，6，12，24，48h进行疼痛评分（VAS），此外，采用状态－特质焦虑量表（State-Trait Anxiety Inventory，STAI）对患者手术前夜以及术后6h，24h，48h的焦虑水平进行评估。术后镇痛应用持续泵入镇痛给药模式，总量100mL，芬太尼1．0mg，负荷量2mL，持续输注2mL／h。【结果】3组患者术后48h内血压、心率、呼吸、脉搏氧饱和度稳定，各组间副反应差异无统计学意义。与安慰剂组相比较，术后48h内G组和c组的疼痛和焦虑评分明显降低。【结论】加巴喷丁和可乐定能够明显减轻子宫全切术患者术后疼痛和焦虑并不增加不良反应的发生率。

[Objective] To investigate the effect of gabapentin and clonidine on postoperative analgesia and anxiety in patients undergoing abdominal hysterectomy. [Methods] Sixty patients （ASA Ⅰ-Ⅱ ） undergoing abdominal hysterectomy were randomly allocated to three groups with 20 cases in each. Group G received oral gabapentinl200mg at night and 2h before surgery and 24h after surgery. Group C received oral clonidinel00ug at night and 2h before surgery and 24h after surgery. Group P took placebo orally. Continuous intravenous infusion pump was used and the bolus infusion （2ml） was given after the operation, and continuous infusion speed was 2mL/ h. In the postoperative period, pain was assessed by using visual analogue scale （VAS） at 2, 6, 12, 24 and 48h. State anxiety was measured at night before the surgery and 6h, 24h and 48h after the operation by using State-Trait Anxiety Inventory （STAI）. [Results]There was no significant difference in the adverse effects and the postoperative mean arterial pressure, heart rate, respiratory rate values and pulse oxygen among three groups. Postoperative anxiety scores were less in the gabapentin and clonidine groups than those of placebo group. In addition, VAS scores were significantly reduced in gabapentin and clonidine groups. [Conclusion] Premedication with 1200mg gabapentin or 100ug clonidine can improve the postoperative anxiety and pain after abdominal hysterectomy without increasing the adverse effects.