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학술저널
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대한안과학회 Korean Journal of Ophthalmology Korean Journal of Ophthalmology 제27권 제4호
발행연도
2013.1
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229 - 234 (6page)

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Purpose: To investigate the analgesic effect and incidence of postoperative nausea and vomiting (PONV)between the opioid fentanyl and the non-steroidal anti-inflammatory drug ketorolac in patients who underwent eye amputation surgery. Methods: Retrospective observational case series. Eighty-two patients underwent evisceration or enucleation surgery by one surgeon over a 2-year period. Fentanyl by intravenous patient-controlled analgesia (IV-PCA)at 20 μg/kg with 12 mg/kg ondansetron or intravenous ketorolac at 2 mg/kg/day was administered to patients at postoperative days 0, 1, and 2. The pain score was measured using an 11-point visual analog scale (VAS). The incidence of severe nausea requiring anti-emetics and the incidence of vomiting were reviewed. Results: The mean postoperative VAS in the fentanyl group was significantly lower than that in the ketorolac group on the day of operation for both types of surgery (p = 0.001 and p = 0.004, respectively). At postoperative days 1 and 2, the mean VAS was not different between the two groups for either surgical type (p > 0.05 for both days). The mean VAS was significantly higher in eviscerated patients than in enucleated patients at postoperative days 0 and 1 in the fentanyl group (p = 0.023 and p = 0.016, respectively). However,this was not observed in the ketorolac group. The incidence of PONV was higher in the fentanyl group than in the ketorolac group, although this was not statistically significant for either surgical type (p > 0.05 for both groups). Conclusions: Fentanyl was more effective as an analgesic than was ketorolac on the day of operation for both surgical types. There was no difference between the two analgesics on postoperative day 1. The analgesic effect of fentanyl in enucleated patients was significantly higher than in eviscerated patients at postoperative days 0 and 1. The use of fentanyl by IV-PCA was associated with greater PONV despite co-administration with anti-emetics, although this finding was not significant.
#Analgesic effect #Eye amputation #Fentanyl #Ketorolac #Postoperative nausea and vomiting

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참고문헌 (22)

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 google schola Ballantyne JC / 1993 / Postoperative patient-controlled analgesia : meta-analyses of initial randomized control trials / J Clin Anesth 5 : 182 ~ 193 google schola Calenda E / 1999 / evisceration of the eye more painful than enucleation? / Eur J Anaesthesiol 16 : 117 ~ google schola Fero KE / 2011 / Pharmacologic management of postoperative nausea and vomiting / Expert Opin Pharmacother 12 : 2283 ~ 2296 google schola Gan TJ / 1997 / Opioid-sparing effects of a low-dose infusion of naloxone in patient-administered morphine sulfate / Anesthesiology 87 : 1075 ~ 1081 google schola

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