加巴喷丁围术期给药预防剖宫产术后慢性疼痛的效果

Effect of perioperative administration of Gabapentin on prevention of chronic pain after cesarean section

目的评价加巴喷丁围手术期给药对剖宫产术后慢性疼痛的影响。方法 84例ASAI~Ⅱ级择期行剖宫产术产妇,按随机数字表法分为加巴喷丁组（J组）和对照组（C组）各42例。加巴喷丁组在术前2小时用少量开水送服600mg加巴喷丁,对照组则给予安慰剂,其它处理方式各组相同。比较两组患者术后1、3、6个月慢性疼痛发生情况及镇痛治疗结束后满意度评价。结果镇痛治疗结束时满意度评价中,两组未见很不满意病例;评价为很满意的J组16例,C组14例,两组比较差异无统计学意义（χ2=0.08,P〉0.05）;评价为不满意的J组2例,明显少于C组的9例（χ2=5.55,P〈0.05）。术后第1、3个月,J组疼痛发生率分别为11.9%、7.1%;C组分别为30.0%、25.0%,两组间比较差异有显著性（χ2值分别为4.08、4.90,均P〈0.05）;术后6个月,J组与C组慢性疼痛发生率分别为4.8%和10.0%,组间比较差异无统计学意义（χ2=0.24,P〉0.05）。结论加巴喷丁围术期给药可较好的预防与降低剖宫产术后患者慢性疼痛的发生率,并能提高患者术后镇痛治疗的满意度。

Objective To evaluate the effect of perioperative administration of Gabapentin on chronic pain after cesarean section. Methods According to random number table,84 cases of pregnant women（ ASAI-II） who received selective cesarean section were divided into Gabapentin group（ J group） and control group（ C group） with 42 cases in each group. In J group,600 mg Gabapentin was given orally at2 hours before operation with a little water. Placebo was given instead in C group. Other treatments were the same in two groups. Incidence of chronic pain at 1,3,6 months after operation and satisfaction after analgesia in two groups were compared. Results There was no extremely dissatisfied case in two groups after analgesia. Altogether 16 cases in J group and 14 cases in C group were extremely satisfied.Difference between two groups was not significant（ χ2= 0. 08,P 〉0. 05）. The dissatisfied cases（ 2） in J group was significantly less than the dissatisfied cases（ 9） in C group（ χ2= 5. 55,P〈 0. 05）. Incidences of pain in J group at 1 and 3 months after operation were 11. 9%and 7. 1% respectively,and those in C group were 30. 0% and 25. 0% respectively. Differences between two groups were significant（ χ2value was 4. 08 and 4. 90,respectively,both P〈 0. 05）. Incidence of chronic pain at 6 months after operation in J group and C group was4. 8% and 10. 0% respectively. Difference between two groups was not significant（ χ2= 0. 24,P 〉0. 05）. Conclusion Perioperative administration of Gabapentin can prevent and reduce incidence of post-cesarean section chronic pain,and improve satisfaction of patients after postoperative analgesia.