麻醉前口服不同剂量普瑞巴林对子宫切除术患者术后疼痛的影响

Effect of Premedicated with Different Dosage of Pregabalin on Pain Intensity in Patients after Hysterectomy

目的评估术前口服不同剂量普瑞巴林(PRE)对子宫切除术患者术后疼痛的影响。方法 ASAⅠ～Ⅱ级、择期行经腹子宫切除术患者80名,随机分为不同剂量普瑞巴林组(PRE组)及安慰剂组(PLA组),每组20例。麻醉前1h,PRE 75组、PRE 150组及PRE 300组患者分别口服PRE 75、150或300mg。患者静吸复合麻醉下手术,苏醒后吗啡静脉自控镇痛(PCIA)。以数字等级评定量表(NRS)评估各组患者术后2、4、8、24h静息与运动状态时的疼痛程度;比较各组患者术后24h内吗啡消耗总量及不良反应。结果 PRE 75、PRE150及PLA组患者术后吗啡负荷剂量及24h内PCA吗啡总用量均明显大于PRE300组(P<0.05);4组患者术后2、4、8、24h静息与运动状态时NRS评分相似且均低于4分(P>0.05);各组不良反应发生率相似(P>0.05)。结论麻醉前口服300mg PRE能显著减少经腹子宫切除术患者术后吗啡用量,术后疼痛控制较佳而无明显不良反应。

Objective To evaluate the effect of premedicated with different dosage of pregabalin on pain after hysterectomy. Meth- ods Eighty ASA I - II patients were included in this prospective, double blind study. They were randomised to receive 75mg, 150mg, or 300rag of pregabalin or placebo one hour before anaesthesia. Anaesthesia was maintained with isoflurane and propofol. Immediately after awake from anaesthesia,patients received morphine intravenously by PCA. The intensity of rest pain and exertion pain at 2 hours,4 hours, 8 hours and 24 hours postoperative were assessed according to numeric rating scale. The total morphine consumption and side effects during 24 hours postoperative were also compared among the four groups. Results Compared to PRE 300rag group,the total morphine consump- tion during 24 hours postoperative was higher in PRE 75mg group, 150mg group and placebo group,respectively. The N RS of rest pain and exertion pain at 2 hours,4 hours, 8 hours and 24 hours postoperative in individual groups was lower than 4 and did not differ significantly. The side effects in individual groups were also did not differ significantly. Conclusion We concluded that premedicated with 300rag pre- gabalin could reduce morphine consumption with lower pain scores during 24 hours postoperative in patients who undergoing hysterectomy, and have no obvious side effects.