위절제술 후 Morphine과 Fentanyl을 이용한 자가조절진통장치의 비교 (Comparison of Morphine and Fentanyl IV-PCA in Gastrectomy Patient)

서지정보

· 발행기관 : 대한마취통증의학회
· 수록지 정보 : Anesthesia and Pain Medicine / 3권 / 2호 / 94 ~ 98페이지
· 저자명 : 방유진

초록

Background: Morphine and fentanyl have potent analgesic effects
and these agents are widely used for intravenous patient controlled
analgesia (IV-PCA); however, these drugs have some side effects.
The purpose of this study was to compare the postoperative
analgesic effects and side effects of morphine and fentanyl,
employing IV-PCA after gastrectomy.
Methods: Fifty patients undergoing gastrectomy were randomized
to receive either morphine (M goup, n = 25) or fentanyl (F group,
n = 25) via an IV-PCA pump for 48 hours after the end of surgery.
The loading dose was administered when a patient first complained
of pain, followed by a bolus dose of 2 mg morphine for the M group
and 20μg fentanyl for the F group, with a lockout interval of 10
minutes between doses. The VAS pain score, PCA opioid
consumption, rescue analgesic requirement, and side effects were
assessed at 2, 6, 12, 24 and 48 hours after the end of surgery.
Results: No significant differences were observed between the
two groups in terms of the VAS pain score, satisfaction score and
total and hourly dose for 48 hours. The side effects were similar
in both groups except that pruritus and urinary retention were
significantly lower in the F group of patients.
Conclusions: We conclude that both morphine and fentanyl have
good analgesic effects with few side effects in gastrectomy patients,
but the fentanyl group of patients experienced less pruritus and
urinary retention than the morphine group of patients.

영어초록

Background: Morphine and fentanyl have potent analgesic effects
and these agents are widely used for intravenous patient controlled
analgesia (IV-PCA); however, these drugs have some side effects.
The purpose of this study was to compare the postoperative
analgesic effects and side effects of morphine and fentanyl,
employing IV-PCA after gastrectomy.
Methods: Fifty patients undergoing gastrectomy were randomized
to receive either morphine (M goup, n = 25) or fentanyl (F group,
n = 25) via an IV-PCA pump for 48 hours after the end of surgery.
The loading dose was administered when a patient first complained
of pain, followed by a bolus dose of 2 mg morphine for the M group
and 20μg fentanyl for the F group, with a lockout interval of 10
minutes between doses. The VAS pain score, PCA opioid
consumption, rescue analgesic requirement, and side effects were
assessed at 2, 6, 12, 24 and 48 hours after the end of surgery.
Results: No significant differences were observed between the
two groups in terms of the VAS pain score, satisfaction score and
total and hourly dose for 48 hours. The side effects were similar
in both groups except that pruritus and urinary retention were
significantly lower in the F group of patients.
Conclusions: We conclude that both morphine and fentanyl have
good analgesic effects with few side effects in gastrectomy patients,
but the fentanyl group of patients experienced less pruritus and
urinary retention than the morphine group of patients.

참고자료

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