Skip to main content
Erschienen in: Surgical Endoscopy 11/2010

01.11.2010

Perioperative administration of pregabalin for pain after robot-assisted endoscopic thyroidectomy: a randomized clinical trial

verfasst von: So Yeon Kim, Jong Ju Jeong, Woong Youn Chung, Hyun Joo Kim, Kee-Hyun Nam, Yon Hee Shim

Erschienen in: Surgical Endoscopy | Ausgabe 11/2010

Einloggen, um Zugang zu erhalten

Abstract

Background

Perioperative administration of pregabalin, which is effective for neuropathic pain, might reduce early postoperative and chronic pain. This randomized, double-blinded, placebo-controlled trial (Clinical Trials.gov ID NCT00905580) was designed to investigate the efficacy and safety of pregabalin for reducing both acute postoperative pain and the development of chronic pain in patients after robot-assisted endoscopic thyroidectomy.

Methods

Ninety-nine patients were randomly assigned to groups that received pregabalin 150 mg or placebo 1 h before surgery, with the dose repeated after 12 h. Assessments of pain and side effects were performed 48 h postoperatively. The incidences of chronic pain and hypoesthesia in the anterior chest were recorded 3 months after surgery.

Results

Ninety-four patients completed the study. Verbal numerical rating scale scores for pain and the need for additional analgesics were lower in the pregabalin group (n = 47) than the placebo group (n = 47) during 48 h postoperatively (P < 0.05). However, incidences of sedation and dizziness were higher in the pregabalin group (P < 0.05). There were no differences between the groups in the incidences of chronic pain and chest hypoesthesia at 3 months after surgery.

Conclusions

Perioperative administration of pregabalin (150 mg twice per day) was effective in reducing early postoperative pain but not chronic pain in patients undergoing robot-assisted endoscopic thyroidectomy. Caution should be taken regarding dizziness and sedation.
Literatur
1.
Zurück zum Zitat Gagner M (1996) Endoscopic subtotal parathyroidectomy in patients with primary hyperparathyroidism. Br J Surg 83:875CrossRefPubMed Gagner M (1996) Endoscopic subtotal parathyroidectomy in patients with primary hyperparathyroidism. Br J Surg 83:875CrossRefPubMed
2.
Zurück zum Zitat Gutt CN, Oniu T, Mehrabi A, Kashfi A, Schemmer P, Buchler MW (2004) Robot-assisted abdominal surgery. Br J Surg 91:1390–1397CrossRefPubMed Gutt CN, Oniu T, Mehrabi A, Kashfi A, Schemmer P, Buchler MW (2004) Robot-assisted abdominal surgery. Br J Surg 91:1390–1397CrossRefPubMed
3.
Zurück zum Zitat Savitt MA, Gao G, Furnary AP, Swanson J, Gately HL, Handy JR (2005) Application of robotic-assisted techniques to the surgical evaluation and treatment of the anterior mediastinum. Ann Thorac Surg 79:450–455 discussion 455CrossRefPubMed Savitt MA, Gao G, Furnary AP, Swanson J, Gately HL, Handy JR (2005) Application of robotic-assisted techniques to the surgical evaluation and treatment of the anterior mediastinum. Ann Thorac Surg 79:450–455 discussion 455CrossRefPubMed
4.
Zurück zum Zitat Gagner M, Inabnet WB III (2001) Endoscopic thyroidectomy for solitary thyroid nodules. Thyroid 11:161–163CrossRefPubMed Gagner M, Inabnet WB III (2001) Endoscopic thyroidectomy for solitary thyroid nodules. Thyroid 11:161–163CrossRefPubMed
5.
Zurück zum Zitat Ikeda Y, Takami H, Sasaki Y, Takayama J, Niimi M, Kan S (2003) Clinical benefits in endoscopic thyroidectomy by the axillary approach. J Am Coll Surg 196:189–195CrossRefPubMed Ikeda Y, Takami H, Sasaki Y, Takayama J, Niimi M, Kan S (2003) Clinical benefits in endoscopic thyroidectomy by the axillary approach. J Am Coll Surg 196:189–195CrossRefPubMed
6.
Zurück zum Zitat Brodner G, Mertes N, Buerkle H, Marcus MA, Van Aken H (2000) Acute pain management: analysis, implications and consequences after prospective experience with 6349 surgical patients. Eur J Anaesthesiol 17:566–575PubMed Brodner G, Mertes N, Buerkle H, Marcus MA, Van Aken H (2000) Acute pain management: analysis, implications and consequences after prospective experience with 6349 surgical patients. Eur J Anaesthesiol 17:566–575PubMed
7.
Zurück zum Zitat Katz J, Jackson M, Kavanagh BP, Sandler AN (1996) Acute pain after thoracic surgery predicts long-term post-thoracotomy pain. Clin J Pain 12:50–55CrossRefPubMed Katz J, Jackson M, Kavanagh BP, Sandler AN (1996) Acute pain after thoracic surgery predicts long-term post-thoracotomy pain. Clin J Pain 12:50–55CrossRefPubMed
8.
Zurück zum Zitat Dahl JB, Mathiesen O, Moiniche S (2004) ‘Protective premedication’: an option with gabapentin and related drugs? A review of gabapentin and pregabalin in the treatment of post-operative pain. Acta Anaesthesiol Scand 48:1130–1136CrossRefPubMed Dahl JB, Mathiesen O, Moiniche S (2004) ‘Protective premedication’: an option with gabapentin and related drugs? A review of gabapentin and pregabalin in the treatment of post-operative pain. Acta Anaesthesiol Scand 48:1130–1136CrossRefPubMed
9.
Zurück zum Zitat Mathiesen O, Moiniche S, Dahl JB (2007) Gabapentin and postoperative pain: a qualitative and quantitative systematic review, with focus on procedure. BMC Anesthesiol 7:6CrossRefPubMed Mathiesen O, Moiniche S, Dahl JB (2007) Gabapentin and postoperative pain: a qualitative and quantitative systematic review, with focus on procedure. BMC Anesthesiol 7:6CrossRefPubMed
10.
Zurück zum Zitat Tiippana EM, Hamunen K, Kontinen VK, Kalso E (2007) Do surgical patients benefit from perioperative gabapentin/pregabalin? A systematic review of efficacy and safety. Anesth Analg 104:1545–1556CrossRefPubMed Tiippana EM, Hamunen K, Kontinen VK, Kalso E (2007) Do surgical patients benefit from perioperative gabapentin/pregabalin? A systematic review of efficacy and safety. Anesth Analg 104:1545–1556CrossRefPubMed
11.
Zurück zum Zitat Jokela R, Ahonen J, Tallgren M, Haanpaa M, Korttila K (2008) A randomized controlled trial of perioperative administration of pregabalin for pain after laparoscopic hysterectomy. Pain 134:106–112CrossRefPubMed Jokela R, Ahonen J, Tallgren M, Haanpaa M, Korttila K (2008) A randomized controlled trial of perioperative administration of pregabalin for pain after laparoscopic hysterectomy. Pain 134:106–112CrossRefPubMed
12.
Zurück zum Zitat Jokela R, Ahonen J, Tallgren M, Haanpaa M, Korttila K (2008) Premedication with pregabalin 75 or 150 mg with ibuprofen to control pain after day-case gynaecological laparoscopic surgery. Br J Anaesth 100:834–840CrossRefPubMed Jokela R, Ahonen J, Tallgren M, Haanpaa M, Korttila K (2008) Premedication with pregabalin 75 or 150 mg with ibuprofen to control pain after day-case gynaecological laparoscopic surgery. Br J Anaesth 100:834–840CrossRefPubMed
13.
Zurück zum Zitat Mathiesen O, Jacobsen LS, Holm HE, Randall S, Adamiec-Malmstroem L, Graungaard BK, Holst PE, Hilsted KL, Dahl JB (2008) Pregabalin and dexamethasone for postoperative pain control: a randomized controlled study in hip arthroplasty. Br J Anaesth 101:535–541CrossRefPubMed Mathiesen O, Jacobsen LS, Holm HE, Randall S, Adamiec-Malmstroem L, Graungaard BK, Holst PE, Hilsted KL, Dahl JB (2008) Pregabalin and dexamethasone for postoperative pain control: a randomized controlled study in hip arthroplasty. Br J Anaesth 101:535–541CrossRefPubMed
14.
Zurück zum Zitat Mathiesen O, Rasmussen ML, Dierking G, Lech K, Hilsted KL, Fomsgaard JS, Lose G, Dahl JB (2009) Pregabalin and dexamethasone in combination with paracetamol for postoperative pain control after abdominal hysterectomy. A randomized clinical trial. Acta Anaesthesiol Scand 53:227–235CrossRefPubMed Mathiesen O, Rasmussen ML, Dierking G, Lech K, Hilsted KL, Fomsgaard JS, Lose G, Dahl JB (2009) Pregabalin and dexamethasone in combination with paracetamol for postoperative pain control after abdominal hysterectomy. A randomized clinical trial. Acta Anaesthesiol Scand 53:227–235CrossRefPubMed
15.
Zurück zum Zitat Reuben SS, Buvanendran A, Kroin JS, Raghunathan K (2006) The analgesic efficacy of celecoxib, pregabalin, and their combination for spinal fusion surgery. Anesth Analg 103:1271–1277CrossRefPubMed Reuben SS, Buvanendran A, Kroin JS, Raghunathan K (2006) The analgesic efficacy of celecoxib, pregabalin, and their combination for spinal fusion surgery. Anesth Analg 103:1271–1277CrossRefPubMed
16.
Zurück zum Zitat Kang SW, Jeong JJ, Nam KH, Chang HS, Chung WY, Park CS (2009) Robot-assisted endoscopic thyroidectomy for thyroid malignancies using a gasless transaxillary approach. J Am Coll Surg 209:e1–e7CrossRefPubMed Kang SW, Jeong JJ, Nam KH, Chang HS, Chung WY, Park CS (2009) Robot-assisted endoscopic thyroidectomy for thyroid malignancies using a gasless transaxillary approach. J Am Coll Surg 209:e1–e7CrossRefPubMed
17.
Zurück zum Zitat Kang SW, Jeong JJ, Yun JS, Sung TY, Lee SC, Lee YS, Nam KH, Chang HS, Chung WY, Park CS (2009) Robot-assisted endoscopic surgery for thyroid cancer: experience with the first 100 patients. Surg Endosc 23:2399–2406 Kang SW, Jeong JJ, Yun JS, Sung TY, Lee SC, Lee YS, Nam KH, Chang HS, Chung WY, Park CS (2009) Robot-assisted endoscopic surgery for thyroid cancer: experience with the first 100 patients. Surg Endosc 23:2399–2406
19.
Zurück zum Zitat Al-Mujadi H, AR AR, Katzarov MG, Dehrab NA, Batra YK, Al-Qattan AR (2006) Preemptive gabapentin reduces postoperative pain and opioid demand following thyroid surgery. Can J Anaesth 53:268–273CrossRefPubMed Al-Mujadi H, AR AR, Katzarov MG, Dehrab NA, Batra YK, Al-Qattan AR (2006) Preemptive gabapentin reduces postoperative pain and opioid demand following thyroid surgery. Can J Anaesth 53:268–273CrossRefPubMed
20.
Zurück zum Zitat Hashizume M, Konishi K, Tsutsumi N, Yamaguchi S, Shimabukuro R (2002) A new era of robotic surgery assisted by a computer-enhanced surgical system. Surgery 131:S330–S333CrossRefPubMed Hashizume M, Konishi K, Tsutsumi N, Yamaguchi S, Shimabukuro R (2002) A new era of robotic surgery assisted by a computer-enhanced surgical system. Surgery 131:S330–S333CrossRefPubMed
21.
Zurück zum Zitat Ben-Menachem E (2004) Pregabalin pharmacology and its relevance to clinical practice. Epilepsia 45(Suppl 6):13–18CrossRefPubMed Ben-Menachem E (2004) Pregabalin pharmacology and its relevance to clinical practice. Epilepsia 45(Suppl 6):13–18CrossRefPubMed
22.
Zurück zum Zitat Agarwal A, Gautam S, Gupta D, Agarwal S, Singh PK, Singh U (2008) Evaluation of a single preoperative dose of pregabalin for attenuation of postoperative pain after laparoscopic cholecystectomy. Br J Anaesth 101:700–704CrossRefPubMed Agarwal A, Gautam S, Gupta D, Agarwal S, Singh PK, Singh U (2008) Evaluation of a single preoperative dose of pregabalin for attenuation of postoperative pain after laparoscopic cholecystectomy. Br J Anaesth 101:700–704CrossRefPubMed
23.
Zurück zum Zitat Lombardi CP, Raffaelli M, Modesti C, Boscherini M, Bellantone R (2004) Video-assisted thyroidectomy under local anesthesia. Am J Surg 187:515–518CrossRefPubMed Lombardi CP, Raffaelli M, Modesti C, Boscherini M, Bellantone R (2004) Video-assisted thyroidectomy under local anesthesia. Am J Surg 187:515–518CrossRefPubMed
24.
Zurück zum Zitat Kavoussi R (2006) Pregabalin: from molecule to medicine. Eur Neuropsychopharmacol 16(Suppl 2):S128–S133CrossRefPubMed Kavoussi R (2006) Pregabalin: from molecule to medicine. Eur Neuropsychopharmacol 16(Suppl 2):S128–S133CrossRefPubMed
25.
Zurück zum Zitat White PF, Tufanogullari B, Taylor J, Klein K (2009) The effect of pregabalin on preoperative anxiety and sedation levels: a dose-ranging study. Anesth Analg 108:1140–1145CrossRefPubMed White PF, Tufanogullari B, Taylor J, Klein K (2009) The effect of pregabalin on preoperative anxiety and sedation levels: a dose-ranging study. Anesth Analg 108:1140–1145CrossRefPubMed
Metadaten
Titel
Perioperative administration of pregabalin for pain after robot-assisted endoscopic thyroidectomy: a randomized clinical trial
verfasst von
So Yeon Kim
Jong Ju Jeong
Woong Youn Chung
Hyun Joo Kim
Kee-Hyun Nam
Yon Hee Shim
Publikationsdatum
01.11.2010
Verlag
Springer-Verlag
Erschienen in
Surgical Endoscopy / Ausgabe 11/2010
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-010-1045-7

Weitere Artikel der Ausgabe 11/2010

Surgical Endoscopy 11/2010 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.