การประเมินผลการระงับปวดหลังผ่าตัดของยา pregabalin ที่ให้โดยวิธีรับประทานก่อนผ่าตัดในผู้ป่วยเข้ารับการผ่าตัดกระดูกสันหลังแบบ laminectomy โดยวิธีเชื่อมกระดูกสันหลัง
บุษกร รักสวย*, ศิริพร ครูปัญญามาตย์, สุวิชนีย์ ผะอบเหล็ก, พจนารถ จุลพันธ์, อุษณี ปั้นเพ็ง
Division of Anesthesiology, Pichit Hospital, Thailand 66000
บทคัดย่อ
Background: Optimal postoperative analgesia with minimal side effects is essential for early mobility and recovery in patients undergoing laminectomy. A combination of opioid and non - opioid analgesic drugs may improve the quality of postoperative analgesia, reduce opioid requirement and their associated side effects after surgery.
Objective: To evaluate the efficacy of a single preoperative oral pregabalin for attenuating postoperative pain and morphine consumption after laminectomy with posterolateral fusion. Methods: Prospective randomized controlled trial was conducted. Sixty patients undergoing elective decompressive lumbar laminectomy with posterolateral fusion were randomly assigned to two groups of 30 patients each. The control group received oral placebo, and the study group received 150 mg of oral pregabalin 2 h before surgery. Postoperative analgesic was 2 mg dose of morphine i.v. every 2 h on request in 24 h. The visual analogue scale
(VAS) scores for pain, sedation scores, total dose of morphine and side effects were recorded for 24 h after surgery.
Results: Postoperative VAS pain scores in the PACU at 4, 8, 12 after operation were significantly lower in pregabalin group compared with the placebo group. Twenty – four – hour morphine consumption was significantly reduced in the pregabalin group compared with the placebo group (5.9 ± 1.4 mg versus 11.9 ± 3.4 mg). Adverse effects were similar in both groups.
Conclusion: A single preoperative 150 mg of oral pregabalin is an effective method for reducing postoperative pain and morphine consumption in patients undergoing decompressive lumbar laminectomy with posterolateral fusion.
 
ที่มา
วิสัญญีสาร ปี 2557, April-June ปีที่: 40 ฉบับที่ 2 หน้า 78-87
คำสำคัญ
Analgesia, postoperative pain, Pregabalin, laminectomy with posterolateral fusion