在腰椎外科手术中比较加巴丁和普雷加巴林用于术后疼痛管理:系统性审查和元分析
Ali Ebada1, Nicholas Bever1, Christopher J Carron1
1Department of Neurological Surgery, The University of Texas Southwestern Medical Center, Dallas, Texas, USA.
World neurosurgery
|July 13, 2025
概括
在腰部手术后, gabapentin (GBP) 和pregabalin (PGB) 并没有显著降低术后疼痛得分. 然而,与安慰剂相比, gabapentin确实减少了24小时的吗啡使用.
科学领域:
- 麻醉学 麻醉学
- 神经外科 神经外科
- 药理学 药理学是指药理学的学科.
背景情况:
- 腰部手术后的急性术后疼痛是一个重大的临床挑战.
- gabapentin (GBP) 和pregabalin (PGB) 是常用的止痛药,但它们在这种情况下的有效性尚未得到充分证实.
- 这项研究旨在评估GGB和PGB在腰椎手术后的急性疼痛管理.
研究的目的:
- 评估 gabapentin (GBP) 和pregabalin (PGB) 在减轻腰部手术后急性术后疼痛方面的有效性.
- 为了比较GBP和PGB对患者报告的疼痛评分和24小时阿片类药物消费的影响.
主要方法:
- 进行了随机临床试验 (RCT) 的系统审查.
- 搜索的数据库包括PubMed/MEDLINE,Scopus和Cochrane等.
- 研究包括接受腰椎手术的成年患者,接受GBP,PGB或安慰剂治疗,报告视觉模拟尺度 (VAS) 疼痛评分和24小时吗啡需求.
主要成果:
- 分析了7个RCT,其中包括724名患者.
- 在GBP,PGB和安慰剂组之间没有观察到24小时VAS疼痛得分的显著差异.
- 与安慰剂相比,接受GBP治疗的患者显示,与安慰剂相比,24小时内吗啡消耗显著减少 (3.80毫克 vs 11.03毫克).
结论:
- 目前的证据是有限的关于GBP和PGB在腰部手术后急性术后疼痛的疗效.
- 虽然英可以减少阿片类药物需求,但无论是英还是PGB都没有显示出明显的疼痛评分降低.
- 需要进一步进行高质量的随机试验,采用标准化方案,以确定它们在术后疼痛管理中的作用.
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