CAJ | 학술논문

目的评价乳腺癌改良根治术患者围手术期单次剂量加巴喷丁对术后丁丙诺啡患者自控静脉镇痛的影响.方法择期全麻下行乳腺癌改良根治术的女性患者60例,ASA分级Ⅰ～Ⅱ级,根据计算机随机数字表法分为加巴喷丁组和安慰剂组,每组30例,分别在麻醉诱导前口服加巴喷丁1200mg或匹配的安慰剂.患者均接受丁丙诺啡患者自控静脉镇痛,共53例完成本研究,安慰剂组28例,加巴喷丁组25例.观察两组术后静息和动态视觉模拟评分(VAS)、术后恶心呕吐(PONV)分级、焦虑程度评分、Ramsay镇静评分、镇痛泵丁丙诺啡用量、第一次患者自控性镇痛时间等.结果加巴喷丁组术后各时间点静息、动态VAS低于安慰剂组(P＜0.05).加巴喷丁组镇痛泵丁丙诺啡用量(506.1±37.9)μg、第一次患者自控性镇痛时间(21.1±2.3)min、PONV发生率为40.0%(10/25)、需追加镇吐药率为12.0%(3/25)、焦虑程度评分(28.5±12.1)分,安慰剂组分别为(699.8±87.8)μg、(4.3±0.8)min、64.3%(18/28)、32.1%(9/28)和(66.3±15.7)分,两组比较差异均有统计学意义(P＜0.05).结论乳腺癌改良根治术患者口服单次剂量的加巴喷丁1200mg能有效缓解术后疼痛、减少丁丙诺啡用量、降低PONV的发生、缓解焦虑.
목적 평개유선암개량근치술환자위수술기단차제량가파분정대술후정병낙배환자자공정맥진통적영향.방법 택기전마하행유선암개량근치술적녀성환자60례,ASA분급Ⅰ～Ⅱ급,근거계산궤수궤수자표법분위가파분정조화안위제조,매조30례,분별재마취유도전구복가파분정1200mg혹필배적안위제.환자균접수정병낙배환자자공정맥진통,공53례완성본연구,안위제조28례,가파분정조25례.관찰량조술후정식화동태시각모의평분(VAS)、술후악심구토(PONV)분급、초필정도평분、Ramsay진정평분、진통빙정병낙배용량、제일차환자자공성진통시간등.결과 가파분정조술후각시간점정식、동태VAS저우안위제조(P＜0.05).가파분정조진통빙정병낙배용량(506.1±37.9)μg、제일차환자자공성진통시간(21.1±2.3)min、PONV발생솔위40.0%(10/25)、수추가진토약솔위12.0%(3/25)、초필정도평분(28.5±12.1)분,안위제조분별위(699.8±87.8)μg、(4.3±0.8)min、64.3%(18/28)、32.1%(9/28)화(66.3±15.7)분,량조비교차이균유통계학의의(P＜0.05).결론 유선암개량근치술환자구복단차제량적가파분정1200mg능유효완해술후동통、감소정병낙배용량、강저PONV적발생、완해초필.
Objective To evaluate the effects of a single preoperative dose of gabapentin on buprenorphine patient controlled intravenous analgesia after modified radical mastectorny. Methods Sixty female patients,ASA physical starus Ⅰ and Ⅱ undergoing modified radical mastectomy under general anesthesia were divided into two groups of 30 each group by random digits table to receive either gabapentin 1200 mg (gabapentin group) or a matching placebo (control group), administered orally 2 h before the induction of anesthesia. Subjects received patient controlled intravenous buprenorphi(n)e analgesia during thepostoperative period. Fifty-three patients finished this study, 28 cases in control group,25 cases in gabapentin group. Postoperative pain (static and dynamic),postoperative nausea and vomiting,anxiety,sedation were assessed by pain visual analogue scale(VAS), four-point ordinal scale, anxiety visual analogue scale, Ramsay sedation scale respectively. Postoperative buprenorphine consumption and time to first patient controlled analgesia were observed. Results Postoperative VAS (static and dynamic) was lower in gabapentin group than that in control group (P ＜0.05). Postoperative buprenorphine consumption was (506.1 ±37.9)μg , time to first patient controlled analgesia was (21.1 ±2.3)min,incidence rate of postoperative nausea and vomiting was 40.0% (10/25), antemetic rate was 12.0% (3/25), grade of anxiety was (28.5 ± 12.1) scores in gabapentin group, (699.8 ± 87.8)μ g, (4.3 ±0.8) min,64.3% (18/28),32.1%(9/28) and (66.3±15.7) scores in control group respectively. There were significant differences between two groups (P ＜ 0.05). Conclusion A single preoperative oral dose of gabapentin 1200 mg can effectively attenuate postoperative pain,reduce the consumption of buprenorphine,decrease the incidence rate of postoperative nausea and vomiting,improve patients' anxiety in patients undergoing modified radical mastectomy under general anesthesia.