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JAMA Surg:围手术期加巴喷丁可减少阿片类止痛药的使用率

2017-12-26 zhangfan MedSci原创

研究认为,围手术期加巴喷丁不能缓解术后疼痛,但可以减少术后阿片类药物使用率,降低慢性阿片药物使用风险

指南建议使用加巴喷丁减少术后疼痛和阿片类药物的使用,但在临床实践中加巴喷丁的镇痛效果存在显著差异。近日研究人员对围手术期加巴喷丁镇痛效果进行了考察。

18-75岁患者参与研究,患者接受了开胸,胸腔镜手术、全髋关节置换、全膝关节置换术,乳房切除术,乳房肿块切除术、手外科、腕管手术、膝关节镜、肩关节置换术和肩关节镜手术。参与者术前服用加巴喷丁1200mg,术后服用3次,每次600mg或术前服用活性安慰剂劳拉西泮,0.5mg,术后72小时服用非活性安慰剂。研究的主要终点是术后疼痛缓解时间,次要终点是阿片类药物停用时间以及6个月至1年期间持续疼痛或阿片类药物使用的受试者比例。

202名参与者服用活性安慰剂,208人接受加巴喷丁治疗。组间基线特征相近。研究发现,术前加巴喷丁不影响疼痛终止时间( HR,1.04;95% CI,0.82-1.33;P=0.73),但接受加巴喷丁治疗者术后阿片类药物使用率降低了24% (HR,1.24;95% CI,1.00-1.54;P=0.05)。未发现严重的不良事件,由于镇静或头晕导致的停药率组间相近(对照组,42/202 [20.8%];加巴喷丁组,52/208 [25.0%])。

研究认为,围手术期加巴喷丁不能缓解术后疼痛,但可以减少术后阿片类药物使用率,降低慢性阿片药物使用风险。

原始出处:


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    2017-12-28 lhlxtx
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