题目加巴喷丁术前给药可改善行开颅术患者术后急性镇痛效果随机.PDFVIP

题目：加巴喷丁术前给药可改善行开颅术患者术后急性镇痛效果： 随机对照实验 摘要翻译：何幼芹 背景：加巴喷丁是一种辅助抗癫痫药物,可减少重大手术急性术后疼 痛。然而，加巴喷丁对经枕下或颞下开颅术术后疼痛的影响尚不清 楚。 方法：本实验采用单中心、随机、安慰剂对照、双盲研究。将 122 例经枕下或颞下入路行择期开颅手术的患者随机分为安慰剂组 和加巴喷丁组。加巴喷丁组于手术前一天晚上及麻醉诱导前2h 均口 服加巴喷丁600 mg ，安慰剂组服用维生素B 。主要观察指标是术后 24 小时运动时的疼痛评分。次要观察指标包括其他时点的疼痛评分， 恶心和呕吐的发生率和镇静及镇痛所消耗药物的剂量。 结果：加巴喷丁能显著降低术后24h 内安静时(p=0.001)和运动时 (p=0.000)的术后急性疼痛评分；然而，它在48h 时对急性疼痛评分 没有影响。加巴喷丁可减少术后呕吐(p=0.047)、减少止吐剂的使用 (p=0.033)和提高术后2h 镇静评分(p0.033) 。此外，加巴喷丁还可降 低术中丙泊酚(0.7mg/kg/h，p=0.021)和瑞芬太尼(1.3µg/kg/h，p=0.025) 的 平均用量；然而，他对术后阿片药物的用量无显著影响。 结论：术前使用加巴喷丁可明显减轻经枕下或颞下开颅手术患者急 性术后疼痛，同时减少呕吐的发生率。然而，当使用加巴喷丁进行 多模式镇痛时应注意术后早期镇静。 文献来源：Zeng M, Dong J, Lin N, et al. Preoperative Gabapentin Administration Improves Acute Postoperative Analgesia in Patients Undergoing Craniotomy: A Randomized Controlled Trial.[J]. J Neurosurg Anesthesiol 2018 Aug 21. 附图： Title : Preoperative Gabapentin Administration Improves Acute Postoperative Analgesia in Patients Undergoing Craniotomy: A Randomized Controlled Trial [Abstract] Background: Gabapentin is an adjuvant antiepileptic agent and helps to reduce acute postoperative pain in several surgery settings. However, the effect of gabapentin on postoperative pain from suboccipital or subtemporal craniotomy is not clear. Methods: The study was a single-center, randomized, placebocontrolled, and double-blinded trial. A total of 122 patients undergoing elective craniotomy by a suboccipital or subtemporal approach were randomly allocated to a placebo group and gabapentin group . The patients received gabapentin (600 mg, orally) the night before surgery and 2 hours before anesthesia induction in the gabapentin group, and patients received vitamin B in the placebo group. The primary outcome was the postoperative pain score on movement at 24 hours. The secondary outcomes