术前口服普瑞巴林对腰椎间盘髓核摘除术患者术前焦虑及术后疼痛的影响  

Influence of Pregabalin on Pre-operative Anxiety and Post-operative Pain in Patients Undergoing Lumbar Discectomy

作　　者：徐燕[1] 葛叶盈[2] 成建庆[2] 袁力勇[2] 

机构地区：[1]浙江省宁波市医疗中心李惠利医院,315040 [2]宁波市第六医院,315040

出　　处：《医学研究杂志》2013年第10期88-92,共5页Journal of Medical Research

基　　金：宁波市优秀中青年卫生技术人才项目(2007201)

摘　　要：目的评估术前口服普瑞巴林（PRE）对腰椎间盘髓核摘除术患者术前焦虑及术后疼痛的影响。方法美国麻醉医师学会（ASA）I～Ⅱ级、择期行腰椎间盘髓核摘除术患者50名，采用数字表法随机分为普瑞巴林组（PRE组）及安慰剂组（PLA组），每组25例。采用单盲试验，由麻醉医生于术前1h分别给予PRE组患者PRE胶囊150rag、PLA组患者空心胶囊。以焦虑视觉模拟评分（VAS）评估患者术前焦虑程度。气管插管静吸复合麻醉下手术，术毕拔除气管导管后行静脉芬太尼自控镇痛（PCIA）。所有患者留置于麻醉苏醒室（PACU）至少2h，术后240min、6h、24h、48h随访，以疼痛VAS评估患者术后疼痛程度。记录比较两组患者麻醉前焦虑VAS；术后30、60、120min疼痛VAS评分、PACU留置时间；术后240min、6h、24h、48h静息痛、运动痛、芬太尼消耗量及不良反应。结果①PRE组患者麻醉前焦虑VAS为3．1±0．8em，PLA组为7．6±2．1em（t=2．579，P=0．010）；②与PLA组相比，PRE组患者术后120rain疼痛VAS较低（t=1．922，P=0．030）；术后120min、240rain、6h、24h及48h时间点，PRE组患者芬太尼消耗量明显低于PLA组（P〈0．05）；③PRE组、PLA组患者PACU留置时间分别为129±8rain、163±38min，PRE组患者留置时间更短（t=1．72，P=0．040）；④术后120rain，麻醉前焦虑VAS与疼痛VAS评分之间的存在正相关（r=0．421，P=0．002）。结论术前1h单次口服150ragPRE能有效减轻腰椎间盘髓核摘除术患者术前焦虑、术后早期（术后120min）疼痛、减少术后PCIA芬太尼用量，且没有明显的不良反应。Objective To evaluate the effect of pregabalin on anxiety before operation and pain after lumbar discectomy. Methods In this single- blind, randomized clinical trial, fifty ASA I - II patients scheduled for lumbar discectomy were studied. Patients were randomly assigned into two groups. One hour before anaesthesia, patients in PRE group received orally pregabalin 150mg, and in PLA group received placebo. The anxiety intensity was assessed before anesthesia using the 10 - piont visual analogue scale（VAS）. Immediate- ly after extubation,all patients received patient - controlled fentanil intravenous analgesia, and stayed at PACU for at least two hours. Thepain intensity was assessed at 30min, 60min, 120min, 240min, 6h, 24h, 48h postoperatively using VAS. The consumption of fentanil and side effects during 48h postoperatively were recorded. Results The VAS of anxiety in PRE group were significantly lower than that in PLA group（t = 2. 579 ,P = 0. 010）. At 120min postoperatively, the VAS of pain in PRE group were significantly lower than that in PLA group（ t = 1. 922,P = 0. 030）. At 120min, 240min, 6h, 24h and 48h postoperatively, the consumption of fentanil in PRE group were sig- nificantly lower than those in PLA group, respectively. Compared to PLAgroup, the time that stay in PACU were shorter in PRE group （t = 1.72 ,P = 0. 040）. The VAS of anxiety pre- operative and VAS of pain at 120minutes postoperative was notable positive correlation（ r = 0. 421 ,P =0. 002）. Conclusion The pre- operative administration of orally dose of 150mg pregabalin effectively alleviated anxiety be- fore anethesia, postoperative early （after 120min） pain, reduced postoperative PCIA fentanil consumption in lumbar discectomy patients.

关 键 词：普瑞巴林 焦虑 疼痛 

分 类 号：R681.53[医药卫生—骨科学]