| Objective: discuss if the application in perioperative period of gabapentin capsule can relieve the severity ofacute pain after thoracotomy,the dosage of analgesic in 24 hours after operation,and occurrence rate of chronic pain,occurrence rate of neuropathic pain in two months of post-operation,so as to improve the life quality of patients.Methods: select 80 cases of patient conforming to inclusion and exclusion criteria,which are randomly divided into four groups-experimental group of G1,experimental group of G2,experimental group of G3 and control group of C,each group has 20 cases.Group G1 takes orally gabapentin capsule of 300mg2 h before operation,and take placebo after operation;group G2 takes gabapentin capsule of 300 mg 2h before operation,and take gabapentin 100mg6 h after operation which keeps 7 days after operation;group G3 takes gabapentin capsule of 300 mg 2h before operation,and take gabapentin 300mg6 h after operation which keeps 7days since the first day after operation;group C is control group,which takes placebo before and after operation.The patients of four groups take intravenous drip of parecoxib sodium for 40 mg 30 min before skin incision,and take a regular application of Patient-Controlled Intravenous Analgesia(recipe: sufentanil 100ug+navoban 5mg,add normal saline to a total mixture of 120ml).Observe the patient's visual analogue scale(VAS score)4h ?8h?12h?24h?48h?72h?96h and 120 h after operation;disposal of intravenous analgesic 24 h after operation,frequency of initiative press bolus,and untoward effects like postoperation somnolence,nausea,vomit,dyspnea,dizziness,blurred vision and pruritus;make a telephone follow-up the patient's occurrence rate of chronic pain 2 months after operation and the occurrence rate of neuropathic pain after operation,and make a comprehensive evaluation of anxiety and sleep quality of patients 2 months after operation.Results: 1.There is no statistical difference in age,gender construction,height,weight,operation time of four groups' patient(P>0.05).2.There is no statistical difference in VAS score 8h after operation of four groups(P>0.05).there is no statistical meaning between G1 and group C 8h after operation(P>0.05);contrasted with G2,G3,group C has statistical difference,G2,G3 has a lower VAS score than group C;compared G2,G3 with G1,G2 and G3 has a lower VAS score than G1 8h after operation(P<0.05);compared G3 with G2,there is no statistical difference in all groups' VAS score within 5 days.3.compare sufentanil dosage and bolus frequency within 24 hours after operation,there is a statistical difference among G1,G2,G3,group C,the two data of G1,G2,G3 is all smaller than group C;the comparison of G2,G3 and G1 has a statistical meaning,all data of G2,G3 is smaller than G1's;there is no obvious statistical meaning between G2 and G3(P>0.05).4.Compare the occurrence rate of postoperation untoward effect,the occurrence of nausea in G1,G2,G3 is lowerthan group C,the difference has a statistical meaning;the occurrence rate of somnolence in group C is lower than G2?G3,G1 is lower than G2,G2 is lower than G3,there is a statistical meaning in all results(P<0.05).5.Compare the occurrence rate of chronic pain 2 months after operation,there is no statistical meaning between G1 and group C;compare G2,G3 with group C,the occurrence rate is lower than group C,which has an obvious statistical meaning(P<0.05);compare G2,G3 with G1,there is a statistical difference,G3 has a lower occurrence rate of chronic pain than G1's;the comparison of G2 and G3 has no statistical meaning.Compare neuropathic pain,there is no statistical meaning in the comparison of G1 and group C;there is a statistical meaning in the comparison of G2,G3 and group C,the occurrence rate is lower than group C's;there is no statistical meaning in the rest.5.Compare the anxiety and sleep quality 2 months after operation,the comparison among G2,G3,group C all has a statistical meaning,the score is smaller than group C's;the comparison of G2,G3 and G1 has a statistical meaning,the score is smaller than G1's;and there is no obvious statistical meaning in the rest.Conclusion:1.The preoperative 300 mg gabapentin has no obvious influence in postoperation acute pain and occurrence rate of chronic pain and neuropathic pain 2 months after operation,but it can decrease the patient's requisite amount of opioid after operation.2 the continuous application of gabapentin before operation and after operation,can reduce the score of postoperation acute pain,the occurrence rate of chronic pain 2 months after operation,as well as theoccurrence rate of untoward effect.3.The application of gabapentin in perioperative period can reduce the occurrence rate of neuropathic pain 2months after operation. |
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