[罂粟摘要]术前口服褪黑素对腰椎间盘术后疼痛的影响：一项双盲随机临床试验

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术前口服褪黑素对腰椎间盘术后疼痛的影响：一项双盲随机临床试验

贵州医科大学  麻醉与心脏电生理课题

翻译:  宋雨婷

编辑:  严旭

审校: 曹莹

背景：尽管外科技术和麻醉技术取得了较大进步，但许多患者在腰椎间盘术后仍感到疼痛。本研究旨在探讨术前口服褪黑素对腰椎间盘切除术后疼痛严重程度的影响。

方法：在这项双盲随机对照临床试验中，选取80名在伊朗萨里伊玛目霍梅尼教育医院行显微椎间盘切除术的择期患者，并将其随机分配至四组。A、B、C和D组的患者在术前一小时分别接受 3mg、5mg 和10mg褪黑素或安慰剂。在术后离开麻醉恢复室之前使用视觉模拟评分量表（VAS），评估术后6小时、12小时和24小时疼痛，恶心呕吐，瘙痒的严重程度和阿片类药物使用情况。

结果：在接受不同剂量褪黑素的三个组中，术后疼痛明显小于安慰剂组（P<0.01）。接受褪黑素治疗的3个组中，术后疼痛的差异无统计学意义（P>0.05）。患者术后24小时内阿片类药物用量在各组间的差异有统计学意义（P=0.043，F=2.58）。术后疼痛分析结果显示，接受5mg褪黑素组与安慰剂组之间存在统计学差异（P = 0.04）。四组未见严重副作用。

结论：术前1小时口服5mg的褪黑素可作为一种较为经济的方法，有效降低术后疼痛以及减少腰椎间盘切除术后阿片类药物的用量。

原始文献来源：

Baradari AG, Habibi MR, Aarabi M, et al. The Effect of Preoperative Oral Melatonin on Postoperative Pain after Lumbar Disc Surgery: A Double-Blinded Randomized Clinical Trial. Ethiop J Health Sci. 2022;32(6):1193-1202.

英文原文：

The Effect of Preoperative Oral Melatonin on Postoperative Pain after Lumbar Disc Surgery: A Double-Blinded Randomized Clinical Trial

Abstract

Background Despite advances in surgical and anesthesiology techniques, many patients continue to experience postoperative pain after lumbar disc surgeries. The aim of this study was to investigate the effect of preoperative oral melatonin on the severity of postoperative pain after lumbar laminectomy/discectomy.

Methods In this double blinded randomized controlled clinical trial 80 patients undergoing an elective mini-open microdiscectomy surgery at Imam Khomeini educational hospital in Sari, Iran, were selected and randomly assigned into one of four groups. Patients in group A, B, C, and D received 3, 5 and 10 mg melatonin or placebo tablets one hour before surgery, respectively. Using the visual analogue scale (VAS) the severity of pain, nausea and vomiting, pruritus, and use of narcotics were assessed immediately after surgery and before leaving the post-anesthesia care unit, 6, 12 and 24 hours postoperatively.

Results In all three groups receiving melatonin at all three different doses, postoperative pain was significantly less than the placebo group (P<0.01). There were no statistically significant differences in postoperative pain level between the three groups receiving melatonin (P>0.05). The amount of opioid received by the patients within 24 hours after surgery had statistically significant differences within the groups (P=0.043, F=2.58). The results of post hoc analysis in terms of postoperative pain intensity showed statistically significant differences between the two groups receiving melatonin at a dose of 5 mg and the placebo group (P=0.04). No serious side effects reported in four groups.

Conclusion The use of oral melatonin with a dose of 5 mg, 1 hour before the surgery as an inexpensive method can effectively reduce pain intensity as well as the amount opioid use after lumbar laminectomy and discectomy.

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