Li Fei, Ma Jianxiong, Kuang Mingjie, Jiang Xuan, Wang Ying, Lu Bin, Zhao Xingwen, Sun Lei, Ma Xinlong
Biomechanics Labs of Orthopaedics Institute, Tianjin Hospital, Tianjin, 300050, People's Republic of China.
Tianjin Medical University, Tianjin, 300070, People's Republic of China.
J Orthop Surg Res. 2017 Mar 24;12(1):49. doi: 10.1186/s13018-017-0540-0.
A systematic review of randomized controlled trials (RCTs) was conducted to evaluate the efficacy of pregabalin for the management of postoperative pain in patients undergoing primary total knee arthroplasty (TKA) and primary total hip arthroplasty (THA).
The PubMed, Embase, Cochrane Central Register of Controlled Trials, and Google Scholar databases were searched for related articles using search strategy. RevMan 5.3 software was selected to conduct the meta-analysis.
Seven RCTs were included in our meta-analysis. There were significant differences in visual analogue scale (VAS) at 24 and 48 h with rest, knee flexion degree, mean morphine consumption, and postoperative side effects (nausea, vomiting, pruritus, and dizziness) when comparing the pregabalin group to the placebo group after TKA and THA. However, the differences in VAS at 72 h with rest and at 24 h on movement were not significant between the two groups.
Pregabalin was found to improve pain control at 24 and 48 h with rest, reduce morphine consumption, improve the knee flexion degree, decrease the incident rate of nausea, vomiting, and pruritus, and increase the incident rate of dizziness after TKA and THA but could not improve the pain control at 72 h with rest. In summary, the use of pregabalin may be a valuable asset in pain management within the first 48 h after TKA and THA. However, future studies regarding doses and pregabalin medication are required.
进行一项随机对照试验(RCT)的系统评价,以评估普瑞巴林用于初次全膝关节置换术(TKA)和初次全髋关节置换术(THA)患者术后疼痛管理的疗效。
使用检索策略在PubMed、Embase、Cochrane对照试验中央注册库和谷歌学术数据库中检索相关文章。选择RevMan 5.3软件进行荟萃分析。
我们的荟萃分析纳入了7项RCT。在TKA和THA后,将普瑞巴林组与安慰剂组进行比较时,静息时24小时和48小时的视觉模拟评分(VAS)、膝关节屈曲度、平均吗啡消耗量以及术后副作用(恶心、呕吐、瘙痒和头晕)存在显著差异。然而,两组之间静息时72小时的VAS以及活动时24小时的VAS差异不显著。
发现普瑞巴林可改善静息时24小时和48小时的疼痛控制,减少吗啡消耗量,改善膝关节屈曲度,降低恶心、呕吐和瘙痒的发生率,并增加TKA和THA后头晕的发生率,但不能改善静息时72小时的疼痛控制。总之,在TKA和THA后的头48小时内,使用普瑞巴林可能是疼痛管理中的一项有价值的措施。然而,需要进一步开展关于剂量和普瑞巴林用药的研究。