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首页> 外文期刊>Pain. >Analgesic and sedative effects of perioperative gabapentin in total knee arthroplasty: a randomized, double-blind, placebo-controlled dose-finding study
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Analgesic and sedative effects of perioperative gabapentin in total knee arthroplasty: a randomized, double-blind, placebo-controlled dose-finding study

机译：围手术期加巴彭在全膝关节间关节置换术中的镇痛和镇静作用：随机，双盲，安慰剂控制的剂量发现研究

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Gabapentin has shown acute postoperative analgesic effects, but the optimal dose and procedure-specific benefits vs harm have not been clarified. In this randomized, double-blind, placebo-controlled dose-finding study, 300 opioid-naive patients scheduled for total knee arthroplasty were randomized (1: 1: 1) to either gabapentin 1300 mg/d (group A), gabapentin 900 mg/d (group B), or placebo (group C) daily from 2 hours preoperatively to postoperative day 6 in addition to a standardized multimodal analgesic regime. The primary outcome was pain upon ambulation 24 hours after surgery, and the secondary outcome was sedation 6 hours after surgery. Other outcomes were overall pain during well-defined mobilizations and at rest and sedation during the first 48 hours and from days 2-6, morphine use, anxiety, depression, sleep quality, and nausea, vomiting, dizziness, concentration difficulty, headache, visual disturbances, and adverse reactions. Pain upon ambulation (visual analog scale, mean [95% confidence interval]) 24 hours after surgery in group A vs B vs C was as follows: 41 [37-46] vs 41 [36-45] vs 42 [37-47], P=0.93. Sedation (numeric rating scale, median [range]) 6 hours after surgery was as follows: 3.2 [0-10] vs 2.6 [0-9] vs 2.3 [0-9], the mean difference A vs C being 0.9 [0.2-1.7], P = 0.046. No between-group differences were observed in overall pain or morphine use the first 48 hours and from days 2-6. Sleep quality was better during the first 2 nights in group A and B vs C. Dizziness was more pronounced from days 2-6 in A vs C. More severe adverse reactions were observed in group A vs B and C. In conclusion, gabapentin may have a limited if any role in acute postoperative pain management of opioid-naive patients undergoing total knee arthroplasty and should not be recommended as a standard of care.
机译：加巴亨坦术表明，急性术后镇痛作用，但尚未澄清最佳剂量和过程特异性益处与危害。在这种随机，双盲，安慰剂控制的剂量查找研究中，预定膝关节间关节置换术的300名阿片类野生患者被随机（1：1：1）进行加巴帕坦1300mg / d（A族），加巴亨坦900毫克除了标准化的多模式镇痛状态外，/ D（组B），或安慰剂（C组）每天从2小时到术后第6天。手术后24小时后，主要结果是疼痛，次要结果在手术后6小时镇静。其他结果是整体疼痛在定义的流动过程中，在前48小时内休息和镇静，从2-6天，吗啡使用，焦虑，抑郁，睡眠质量和恶心，呕吐，头晕，集中困难，头痛，视觉干扰和不良反应。气动疼痛（视觉模拟规模，平均值[95％置信区间]）术后24小时，VS B VS C如下：41 [37-46] Vs 41 [36-45] Vs 42 [37-47 p = 0.93。镇静（数值评定量表，中位数[范围]）手术后6小时如下：3.2 [0-10] Vs 2.6 [0-9]，平均差异为0.9 [0.2 -1.7]，p = 0.046。在整体疼痛或吗啡中没有观察到组之间的差异，使用前48小时和2-6天。睡眠质量在A组和B族的前2个晚上更好，B vs C.在VS C中的2-6天比较眩晕更加明显。在A组VS B和C组中观察到更严重的不良反应。总之，加巴亨坦可能如果在进行膝关节关节置换术中的阿片类静脉患者急性术后疼痛管理中的任何作用，则有一个有限的作用。

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