배경 : 하지의 운동 신경 차단은 초기 보행을 방해하고 환자 조절 통증조절 장치 (PCEA) 사용을 제한한다. 국소 신경 마취제의 농도가 PCEA의 가장 중요한 요소이다. 우리는 0.075% ropivacaine과 0.15% ropivacaine에서 하지의 운동 신경 차단과 다른 부작용을 비교하였다.
방법 : 복강경하 산부인과 수술을 하는 70명을 R1그룹 0.15% ropivacaine with fentanyl R2그룹 0.075% ropivacaine with fentanyl으로 나누어 통증 정도, 차단 정도, 저혈압, 오심, 구토, 소양감, 어지러움 등의 부작용을 측정하였다.
결과 : 두 그룹 상에서 유의한 차이는 없었다. 운동 신경 차단이 R1그룹에서 R2그룹보다 더 빈번하게 나타났다.
결론 : 저농도의 ropivacaine with fentanyl이 고농도의 ropivacaine with fentanyl보다 운동신경 차단이 적으면서 comparable analgesia를 제공하였다.
M.S. Thesis
A comparison of 0.075% and 0.15% of ropivacaine with fentanyl for postoperative patient controlled epidural analgesia after laparoscopic gynecologic surgery
Jung Hyun-Chul
Department of Anethesiology and Pain Medicine Graduate School Yeungnam University (Supervised by Professor Park Sang-Jin)
ABSTRACT
Background: Motor blockade of lower limbs interferes with early ambulation and limits the usefulness of patient controlled epidural analgesia (PCEA). The concentration of local anesthetic solution is a major determinant of motor block with PCEA. We compared the effects of epidural infusion of 0.075% ropivacaine on postoperative analgesia, motor block of lower limbs, and other side effects with 0.15% epidural ropivacaine. Methods: All 70 patients undergoing laparoscopic gynecologic surgery received epidural infusions (Group R1: 0.15% ropivacaine with fentanyl, or Group R2: 0.075% ropivacaine with fentanyl). Pain score, motor block, and side effects (hypotension, nausea, vomiting, pruritus, urinary retention, dizziness, and numbness) were measured. Results: There were no significant differences in demographic profiles between the groups. Pain scores of the group R1 and the group R2 were not significantly different. Motor block was more frequent in group R1 (0.15% ropivacaine with fentanyl) than group R2 (0.075% ropivacaine with fentanyl). Conclusion: Lower concentration of ropivacaine (0.075%) and fentanyl provide comparable analgesia with less motor block of lower limbs as higher concentration of ropivacaine (0.15%) with fentanyl for PCEA.
Keywords: Epidural analgesia; Ropivacaine; Side effect; Concentration
목차
INTRODUCTION 1MATERIALS AND METHODS 2RESULTS 5DISCUSSION 6REFERENCES 9Korean Abstract 16