지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2014.1
- 수록면
- 1,106 - 1,114 (9page)
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초록· 키워드
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Purpose: Epidural analgesia has been the preferred analgesic technique after major abdominal surgery. On the other hand, the combined use of intrathecal morphine (ITM) and intravenous patient controlled analgesia (IVPCA) has been shown to be a viable alternative approach for analgesia. We hypothesized that ITM combined with IVPCA is as effective as patient controlled thoracic epidural analgesia (PCTEA)with respect to postoperative pain control after conventional open gastrectomy. Materials and Methods: Sixty-four patients undergoing conventional open gastrectomy due to gastric cancer were randomly allocated into the intrathecal morphinecombined with intravenous patient-controlled analgesia (IT) group or patient-controlled thoracic epidural analgesia (EP) group. The IT group received preoperative0.3 mg of ITM, followed by postoperative IVPCA. The EP group preoperatively underwent epidural catheterization, followed by postoperative PCTEA. Visual analogscale (VAS) scores were assessed until 48 hrs after surgery. Adverse effects relatedto analgesia, profiles associated with recovery from surgery, and postoperative complications within 30 days after surgery were also evaluated. Results: This study failed to demonstrate the non-inferiority of ITM-IVPCA (n=29) to PCTEA (n=30) with respect to VAS 24 hrs after surgery. Furthermore, the IT group consumed more fentanyl than the EP group did (1247.2±263.7 μg vs. 1048.9±71.7 μg, p<0.001). The IT group took a longer time to ambulate than the EP group (p=0.021) and had higher incidences of postoperative ileus (p=0.012) and pulmonary complications (p=0.05) compared with the EP group. Conclusion: ITM-IVPCA is not as effective as PCTEA in patients undergoing gastrectomy, with respect to pain control, ambulation,postoperative ileus and pulmonary complications.
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참고문헌 (26)
참고문헌 신청
Meierhenrich R / 2011 / Analgesia and pulmonary function after lung surgery: is a single intercostal nerve block plus patient-controlled intravenous morphine as effective as patient-controlled epidural anaesthesia? A randomized non-inferiority clinical trial / Br J Anaesth 106:580~589
Bauer C / 2007 / Lung function after lobectomy: a randomized, double-blinded trial comparing thoracic epidural ropivacaine/sufentanil and intravenous morphine for patient-controlled analgesia / Anesth Analg 105:238~244
Holte K / 2002 / Pathophysiology and clinical implications of perioperative fluid excess / Br J Anaesth 89:622~632
Olsén MF / 2011 / Fast-track concepts in major open upper abdominal and thoracoabdominal surgery: a review / World J Surg 35:2586~2593
Beaussier M / 2006 / Postoperative analgesia and recovery course after major colorectal surgery in elderly patients: a randomized comparison between intrathecal morphine and
Bauer C / 2007 / Lung function after lobectomy: a randomized, double-blinded trial comparing thoracic epidural ropivacaine/sufentanil and intravenous morphine for patient-controlled analgesia / Anesth Analg 105:238~244
Holte K / 2002 / Pathophysiology and clinical implications of perioperative fluid excess / Br J Anaesth 89:622~632
Olsén MF / 2011 / Fast-track concepts in major open upper abdominal and thoracoabdominal surgery: a review / World J Surg 35:2586~2593
Beaussier M / 2006 / Postoperative analgesia and recovery course after major colorectal surgery in elderly patients: a randomized comparison between intrathecal morphine and
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