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我们无缘无故地做的事情TM:为疼痛处方 gabapentinoids
Niti G Patel1, David Goese1, Steven M Belknap2
1Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Journal of hospital medicine
|February 16, 2026
概括
gabapentin和pregabalin在非标记性疼痛中提供有限的益处,但具有重大风险,如镇静和滥用. 建议使用抑郁和非药物治疗,而不是常规阿片类药物替代.
科学领域:
- 药理学 药理学是指药理学的学科.
- 临床医学 临床医学
- 疼痛管理 疼痛管理
背景情况:
- 加巴丁和普雷加巴林在美国经常被处方.
- 大多数处方是用于非标签疼痛指示,超过FDA批准的用途.
研究的目的:
- 评估 gabapentinoids 在非标签疼痛管理中的有效性和安全性.
- 为适当的临床使用和替代品提供指导.
主要方法:
- 对治疗疼痛的 gabapentinoids 随机对照试验的综述.
- 分析与 gabapentinoid 使用相关的不良事件和风险.
主要成果:
- 随机试验表明,对于大多数非标记性疼痛综合征来说,益处最小或临床上无关紧要.
- gabapentinoids 与不良影响有关,包括镇静,跌倒,妄想和呼吸抑制.
- 当与阿片类药物一起使用或在患有功能障碍的患者中使用时,风险会增加.
结论:
- 有限的疗效和显著的危害表明, gabapentinoids 不应该经常取代阿片类药物.
- 临床医生应该重新评估指示,考虑减轻处方,并优先考虑非药物疼痛管理策略.
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