围手术期使用普瑞巴林对非小细胞肺癌患者术后情绪及睡眠的影响

Effect of perioperative pregabalin on postoperative mood and sleep in patients with non‑small cell lung cancer

目的:探讨围手术期使用普瑞巴林对非小细胞肺癌患者术后情绪及睡眠的影响。方法:选取2022年9月至2022年10月在徐州医科大学附属医院接受胸腔镜下肺切除手术的患者60例,采用随机数字表法分成观察组和对照组(每组30例)。两组患者术后均采用患者自控静脉镇痛,对照组患者口服安慰剂,观察组患者于术前1~2 h口服普瑞巴林150 mg,术后1~5 d口服普瑞巴林75 mg,每日2次。记录两组患者术前及术后第1、2、3、7、30天焦虑、抑郁发生率;记录两组患者术前及术后第1、2、3、7天阿森斯量表(Athens Insomnia Scale, AIS)评分和VAS疼痛评分,同时记录两组患者术后第30天匹兹堡睡眠质量指数(Pittsburgh sleep quality index, PSQI)和VAS疼痛评分;采用围手术期疲劳评测量表(Identity-Consequence Fatigue Scale, ICFS)记录两组患者术前及术后第1、3、7、30天的疲劳评分;比较两组患者术后第1、2、3天不良反应发生率。结果:观察组术后第1、2、3天焦虑、抑郁发生率及AIS评分,术后第1、2、3、7天VAS疼痛评分,术后第1、3、7、30天ICFS评分均低于对照组( P<0.05)。两组患者术后第3、7、30天焦虑发生率均低于术前( P<0.05);两组患者术后第1、2、3、7、30天VAS疼痛评分,术后第1、3、7、30天ICFS评分均高于术前( P<0.05);两组患者术后第30天PSQI评分差异无统计学意义( P>0.05)。观察组术后第2天焦虑发生率,术后第30天抑郁发生率低于术前( P<0.05);观察组术后第1天抑郁发生率,术后第1、2、7天AIS评分均高于术前( P<0.05)。对照组术后第1、2天抑郁发生率,术后第1、2、3天AIS评分均高于术前( P<0.05)。其余指标差异无统计学意义( P>0.05)。 结论:围手术期使用普瑞巴林可以缓解非小细胞肺癌患者术后焦虑、抑郁情绪,改善术后睡眠质量,减轻术后疼痛和疲劳程度,且未提高不良反应发生率。

Objective To discuss the effect of pregabalin on postoperative mood and sleep in patients with non‑small cell lung cancer.Methods A total of 60 patients who underwent thoracoscopic pneumonectomy in the Affiliated Hospital of Xuzhou Medical University from September 2022 to October 2022 were selected.According to the random number table method,they were di‑vided into two groups(n=30):an observation group and a control group.After surgery,all the patients were given patient‑controlled in‑travenous analgesia.Patients in the control group orally took placebo,while those in the observation group orally took 150 mg pregaba‑lin 1‒2 h before operation and 75 mg pregabalin 1‒5 days after operation,twice a day.The incidences of anxiety and depression were recorded before operation and on days 1,2,3,7,and 30 after operation.The Athens Insomnia Scale(AIS)scores and Visual Analogue Scale(VAS)scores were recorded before operation and on days 1,2,3 and 7 after operation.Meanwhile,their Pittsburgh sleep quality index(PSQI)and VAS scores were recorded on day 30 after operation.The Identity‑Consequence Fatigue Scale(ICFS)was used to re‑cord patients'fatigue scores before operation and on days 1,3,7 and 30 after operation.The incidences of adverse events on days 1,2 and 3 after operation were compared between the two groups.Results Compared with the control group,the observation group showed decreases in the incidences of anxiety and depression and AIS scores on days 1,2 and 3 after operation,VAS scores on days 1,2,3 and 7 after operation,and the scores of ICFS on days 1,3,7 and 30 after operation(P<0.05).Both groups exhibited reduced inci‑dences of anxiety on days 3,7 and 30 after operation,compared with those before operation(P<0.05).Moreover,the VAS scores on days 1,2,3,7 and 30 after operation and the scores of ICFS on days 1,3,7 and 30 after operation were higher in both groups than those before operation(P<0.05).There was no statistical difference in PSQI score on day 30 after the operation between the two groups(P>0.05).For the observation group,the incidence of anxiety on day 2 after operation,and the incidence of depression on day 30 after oper‑ation were lower than those before operation(P<0.05).The observation group showed increases in the incidence of depression on day 1 after operation and AIS scores on days 1,2 and 7 after operation,compared with those before operation(P<0.05).For the control group,the incidence of depression on days 1 and 2 after operation and AIS scores on days 1,2 and 3 after operation were higher than those be‑fore operation(P<0.05).There was no statistical difference in other indexes(P>0.05).Conclusions Perioperative use of pregabalin can relieve postoperative anxiety and depression in patients with non-small cell lung cancer,improve postoperative sleep quality,and reduce postoperative pain and fatigue without increasing the incidence of side effects.