口服普瑞巴林在胸腔镜肺癌根治术后疼痛中的临床疗效观察*

CLINICAL OBSERVATION OF PREALIN IN THE PAIN AFTER RADICAL OPERATION OF THORACOSCOPIC LUNG CANCER*

摘要:

目的 探讨普瑞巴林在胸腔镜肺癌根治术后疼痛中的临床疗效及安全性。方法 收集2016年10月至2017年10月四川省人民医院胸外科诊治的肺癌需行胸腔镜肺癌根治术患者90例；将患者随机分为三组,每组30例患者,低剂量组(G1组)、高剂量组(G2组)和对照组(C组)；G1组和G2组分别于术前2 h口服普瑞巴林胶囊75 mg和150 mg,手术后第1-7 d分别服用普瑞巴林胶囊75 mg bid和150 mg bid。C组术前2 h口服加巴喷丁0.3 mg,手术后第1-7 d分别服用加巴喷丁胶囊0.3 mg tid。术中丙泊酚、瑞芬太尼维持麻醉,术后均常规应用静脉镇痛泵进行术后自控镇痛。观察诱导前的镇静评分(Ramsay评分)、术后2 h、4 h、8 h、24 h和48 h病人的疼痛视觉模拟评分(VAS评分)、静脉镇痛药使用量及术后恶心、呕吐、头晕及嗜睡等不良反应；术后48小时用状态-特质焦虑量表(STAI)和匹兹堡睡眠质量指数量表(PSQI)评估患者的焦虑和睡眠质量。结果G1、G2组诱导前Ramsay评分均高于C组,G2组高于G1组,差异有统计学意义(P < 0.05),G1、G2组患者丙泊酚用量、瑞芬太尼用量均显著少于C组,G2组用量少于G1组,差异有统计学意义(P < 0.05)；G1、G2组患者术后2 h、4 h、8 h、24 h和48 h VAS评分均低于C组,G2组与G1组相比,G2组评分低于G1组,差异有统计学意义(P < 0.05)；G1、G2组患者术后STAI评分、PSQI评分低于C组,G2组与G1组相比,G2组评分低于G1组,差异有统计学意义(P < 0.05)。结论 普瑞巴林在胸腔镜肺癌根治术中能够有效缓解术后疼痛,减少术中麻醉药物用量,值得推广应用。

Abstract:

objective: To observe clinical effIcacy and safety of Pregabalin on the postoperative pain of thoracoscopic lung cancer. Methods: 90 patients with the inclusion and exclusion criteria were selected and randomly divided into three groups, the experimental group G1 group, the experimental group G2 group and the control group C group, each group of 30 patients. The G1 and G2 groups were given the preoperative 2h of the Pregabalin capsule 75mg and 150mg respectively, and the postoperative 7d was taken with the pretreatment of the Pregabalin capsule 75mg bid and 150mg bid respectively. Preoperative group C were given the preoperative 2h of Gabapentin capsule 0.3mg , and the postoperative 7d was taken with the pretreatment of the Gabapentin capsule 0.3mg tid. Intranperative Propofol and Remifentanil were used to maintain anesthesia.Postoperative controlled analgesic pain was used for postoperative analgesia. Preinduction Sedation score (Ramsay score),The visual analogue scores (VAS scores) of 2h, 4h, 8h, 24h and 48h patients were observed.; The use of intravenous analgesics and adverse reactions including nausea, vomiting, dizziness and drowsiness after surgery; with state - trait anxiety inventory (STAI) and Pittsburgh sleep quality index scale (PSQI) to assess the patient"s anxiety and sleep quality. Results: The dosage of propofol、Remifentanil in G1 and G2 group was significantly lower than that in group C (P < 0.05), The dosage of G2 group was less than that of G1 group,which was statistically significant. G1 and G2 groups showed significant differences in 2h, 4h, 8h, 24h and 48h VAS scores with group C (P < 0.05), Compared with G1 group, G2 group scored lower than G1 group,which was statistically significant. In the G1 and G2 group, STAI score, PSQI score, Ramsay score and group C were statistically significant (P < 0.05),Compared with G1 group, G2 group scored lower than G1 group.Conclusion: the application of Pregabalin in the radical surgery of thoracoscopic lung cancer can alleviate the postoperative pain and reduce the dosage of anesthetic drugs.