액와접근법을 이용한 무기하 내시경 갑상선 절제술 후 국소 부위 통증 조절 장치(On-QⓇ PainBusterⓇ)와 자가 통증 조절 장치의 무작위 대조 연구에 대한 예비 자료

이경원; 박찬흔; 박용래; 현기훈; 윤지섭

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자료유형: 학술저널

저자정보: 이경원 박찬흔 박용래 현기훈 윤지섭

저널정보: 대한갑상선-내분비외과학회 The Journal of Endocrine Surgery The Journal of Endocrine Surgery 제13권 제4호

발행연도: 2013.1

수록면: 257 - 261 (5page)

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연구주제

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연구배경

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연구방법

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Purpose: Gasless transaxillary approach to endoscopic thyroidectomy is a widely performed procedure for benign or malignant thyroid neoplasms. However, it requires wide dissection for approaching the target area. The intravenous patient-controlled analgesia (IV PCA) is an effective method for postoperative pain control and patients can use it according to their requirement. However, patients suffer from nausea, vomiting, sleep disturbance, etc. due to opioids. Pain pump ON-QⓇ PainBusterⓇ (pain buster) has been used widely in various surgeries for control of postoperative localizing and wide area pain without side effects of opioid analgesia because it consists of Ropivacaine.Methods: From Aug. 2008 to Jan. 2013, Gasless transaxillary endoscopic thyroidectomy was performed in 90 patients in a single institution, who were divided into three groups, including the IV PCA, pain buster, and null groups. We compared postoperative outcomes, pain severity between groups. We recorded scores immediately, 6, 12, 24, and 48 hours after surgery following visual analog pain score (VAS), and investigated hospital stay and occurrence of events of nausea, vomiting, and complications.Results: In the IV PCA group, it was discontinued due to nausea in 36.7% of patients. No significant difference in pain severity following VAS score was observed among the three groups. However, smaller numbers of analgesia injections were required in the Pain buster group than in the other groups, and fewer patients suffered from constipation, compared with the PCA group.Conclusion: Pain buster showed even effects compared to IV PCA, with few side effects and less discomfort of patients, compared with the other groups. Therefore, pain buster was thought to be the proper method for pain control after dissection of the anterior chest wall, cervical area in order to secure an operative view for transaxillary endoscopic thyroi-dectomy.

#내시경 갑상선 절제술 #무기하 액와 접근법 #수술 후 통증 조절 #Endoscopic thyroidectomy #Gasless transaxillary approach #Postoperative pain control

참고문헌 (21)

참고문헌 신청

Apfel CC / 1999 / A simplified risk score for predicting postoperative nausea and vomiting: conclusions from cross-validations between two centers / Anesthesiology 91 : 693

Baig MK / 2006 / Use of the ON-Q pain management system is associated with decreased postoperative analgesic requirement: double blind randomized placebo pilot study / J Am

Chao TC / 2004 / Gasless video-assisted total thyroidectomy in the treatment of low risk intrathyroid papillary carcinoma / World J Surg 28 : 876 ~ 879

Chung YS / 2007 / Endoscopic thyroidectomy for thyroid malignancies: comparison with conventional open thyroidectomy / World J Surg 31 : 2302 ~ 2306

Duncan TD / 2007 / Endoscopic transaxillary approach to the thyroid gland: our early experience / Surg Endosc 21 : 2166 ~ 2171