Abstract:Objective To investigate the effect of different doses of Pregabalin on postoperative pain undergoing radical resection of esophageal cancer under thoracoscopy. Methods A total of 120 patients underwent radical resection of esophageal cancer under thoracoscopy in the First Affiliated Hospital of Nanjing Medical University from January 2019 to January 2020 were selected as the research objects. The patients were divided into group P1 (low-dose pregabalin,30 cases), group P2 (medium-dose pregabalin, 30 cases), group P3 (high-dose pregabalin, 30 cases) and group C (no pregabalin, 30 cases) by random number table method. Patients in group P1 received orally Pregabalin concentration of 75 mg respectively, at 8 pm a night before surgery, 1 h before surgery and 6 h after surgery. Patients in group P2 received orally Pregabalin concentration of 150 mg respectively, at 8 pm a night before surgery, 1 h before surgery and 6 h after surgery. Patients in group P3 received orally Pregabalin concentrations of 300 mg respectively, at 8 pm a night before surgery, 1 h before surgery and 6 h after surgery, whereas group C received no oral analgesic drugs at the same scheme. The visual analogue score (VAS) in resting and cough state, Ramsay score in anaestheti-induced sedation(Ramsay), and 2 h after operation in the recovery room (T0), 2 h after operation (T1), 6 h after operation (T2), 12 h after operation (T3), 24 h after operation (T4) and 48 h after operation (T5), Pittsburgh Sleep Quality Index (PSQI) score, 48 h postoperative intravenous controlled analgesia pump (PCIA) dosage, dizziness, nausea and vomiting, visual impairment,pruritus, peripheral edema and other adverse reactions were compared. Results VAS scores in T0, T1, T2, T3, T4 and T5 in groups P1, P2 and P3 were lower than those in group C in resting and coughing state, and the differences were statistically significant (P<0.05). The Ramsay score be-fore induction of group P1, P2, P3 were lower than those of group C, and the differences were statistically significant(P<0.05). The PSQI score of group P1, P2, P3 were lower than those of group C, and the differences were statistically significant (P<0.05). The dosage of analgesics in PCIA of group P1, P2, P3 were lower than those of group C, the dosage of Group P2, P3 were lower than those of Group P1, the dosage of group P3 was lower than that of group P2,and the differences were statistically significant (P<0.05). The incidence of dizziness of group P3 was lower than that of group P1, P2, C, and the differences were statistically significant (P<0.05). Conclusion The application of Pregabalin in the radical surgery of thoracoscopic esophageal cancer can alleviate the postoperative pain, and oral administration of 150 mg Pregabalin is an effective and safe method for postoperative pain management after radical resection of esophageal cancer under thoracoscopy.
Zhang Z,Li H,Yan C,et al.A comparative study on the efficacy of fast-track surgery in the treatment of esophageal cancer patients combined with metabolic syndrome[J].Oncol Lett,2017,14(4):4812-4816.
[4]
Szedlák B,Mitre C,Fülesdi B.Preemptive and preventive analgesia-an important element in perioperative pain management[J].Orv Hetil,2018,159(17):655-660.
[5]
Homma T,Doki Y,Yamamoto Y,et al.Efficacy of 50 mg pregabalin for prevention of postoperative neuropathic pain after video-assisted thoracoscopic surgery and thoracotomy:a 3-month prospective randomized controlled trial [J].J Thorac Dis,2019,11(3):694-701.
[6]
Lee S,Kim Y,Lee JJ,et al.A pharmacokinetic drug-drug interaction study between pregabalin and tramadol in healthy volunteers[J].Eur J Clin Pharmacol,2018,74(12):1605-1613.
[7]
Li S,Zhang W,Cheng S,et al.Does pregabalin effectively and safely relieve postoperative pain in patients undergoing pulmonary resections?[J].Interact Cardiovasc Thorac Surg,2019,29(4):555-560.
[8]
Ramsay MA,Savege TM,Simpson BR,et al.Controlled sedation with alphaxalone-alphadolone[J].Br Med J,1974,2(5920):656-659.
[9]
Buysse DJ,Reynolds CF 3rd,Monk TH,et al.The Pittsburgh Sleep Quality Index:a new instrument for psychiatric practice and research[J].Psychiatry Res,1989,28(2):193-213.
[10]
Sun K,Liu D,Chen J,et al.Moderate-severe postoperative pain in patients undergoing video-assisted thoracoscopic surgery:A retrospective study[J].Sci Rep,2020,10(1):795.
[11]
Said AM,Zubovic E,Ha AY,et al.Effects of Single-dose Preoperative Pregabalin on Postoperative Pain and Opioid Consumption in Cleft Orthognathic Surgery[J].J Craniofac Surg,2021,32(2):517-520.
[12]
Dolin SJ,Cashman JN.Tolerability of acute postoperative pain management:nausea,vomiting,sedation,pruritis,and urinary retention.Evidence from published data[J].Br J Anaesth,2005,95(5):584-591.
Dahmardeh AR,Moosavi A,Tabatabaei NA,et al.The Effect of a Single Dose Oral Pregabalin on Hemodynamic Changes and Duration of Analgesia after Spinal Anesthesia in Orthopedic Surgeries of Tibial Fractures[J].J Pharm Res,2018,17(Suppl):2-7.
[15]
Chincholkar M.Analgesic mechanisms of gabapentinoids and effects in experimental pain models:a narrative review[J].Br J Anaesth,2018,120(6):1315-1334.
[16]
Asgari Z,Rouholamin S,Nataj M,et al.Dose ranging effects of pregabalin on pain in patients undergoing laparoscopic hysterectomy:A randomized,double blinded,placebo controlled,clinical trial[J].J Clin Anesth,2017,38:13-17.
[17]
Bockbrader HN,Wesche D,Miller R,et al.A Comparison ofthePharmacokineticsandPharmacodynamics of Pregabalin and Gabapentin[J].Clin Pharmacokinet,2010,49(10):661-667.
[18]
Routray SS,Pani N,Mishra D,et al.Comparison of pregabalin with gabapentin as preemptive analgesic in lumbar spine surgery[J].J Anaesthesiol Clin Pharmacol,2018,34(2):232-236.
[19]
Bala R,Kaur J,Sharma J,et al.Comparative Evaluation of Pregabalin and Clonidine as Preemptive Analgesics for the Attenuation of Postoperative Pain Following Thoracolumbar Spine Surgery[J].Asian Spine J,2019,13(6):967-975.
Yu Y,Liu N,Zeng Q,et al.The efficacy of pregabalin for the management of acute and chronic postoperative pain in thoracotomy:a meta-analysis with trial sequential analysis of randomized-controlled trials[J].J Pain Res,2018,28(12):159-170.
[22]
Han C,Kuang MJ,Ma JX,et al.Is pregabalin effective and safe in total knee arthroplasty?A PRISMA -compliant meta-analysis of randomized-controlled trials[J].Medicine,2017,96(26):e6947.
[23]
Sarakatsianou C,Theodorou E,Georgopoulou S,et al.Effect of pre-emptive pregabalin on pain intensity and postoperative morphine consumption after laparoscopic cholecystectomy[J].Surg Endosc,2013,27(7):2504-2511.
[24]
Jokela R,Ahonen J,Tallgren M,et al.A randomized controlled trial of perioperative administration of pregabalin for pain after laparoscopic hysterectomy[J].Pain,2008,134(1-2):106-112.