복부수술을 받는 노인 환자의 경막외 통증 조절 시 0.2%와 0.25% Levobupivacaine의 효과와 안전성 비교 (Comparison of the Efficacy and Safety of Two Different Concentrations (0.2% & 0.25%) Levobupivacaine Infused Epidurally as Analgesia for Elderly Patients Undergoing Abdominal Surgery)

서지정보

· 발행기관 : 대한마취통증의학회
· 수록지 정보 : Anesthesia and Pain Medicine / 2권 / 2호 / 91 ~ 97페이지
· 저자명 : 권원경

초록

Background: Levobupivacaine appears attractive as epidural analgesia
because it is less cardio- and neurotoxic than its racemic mixture.
This study evaluated the efficacy and safety of two different
concentrations of levobupivacaine infused epidurally as analgesia for
elderly patients undergoing abdominal surgery.
Methods: This prospective study evaluated the quality of postoperative
analgesia, the six graded physical activity score, the time to
the first passage of flatus, the time to the first oral intake of clear
fluid, and the postoperative hospital stay in patients who received
a continuous thoracic epidural infusion of levobupivacaine at two
different concentrations over a 48 hour period: Group 0.2% (n =
15) or Group 0.25% (n = 15). The incidence of side effects, such
as motor block, hypotension, and bradycardia, was also assessed.
Results: There were no differences with regard to the verbal
numerical rating scale at rest and cough, the total consumption of
rescue analgesia, the incidence of side effects, and the overall
satisfaction. The physical activity scores at postoperative 24 and
48 hours were similar in both groups. However, the time to the first
passage of flatus and time to the first oral intake of clear fluid was
significantly faster in Group 0.25% than in Group 0.2% (P ＜ 0.05).
Conclusions: The continuous thoracic epidural infusion of
levobupivacaine in elderly patients after abdominal surgery at both
0.2% and 0.25% provides a similar quality of analgesia without any
significant motor block. However, increasing the concentration to 0.25% provides a more rapid return of the bowel function but does
not shorten the postoperative hospital stay.

영어초록

Background: Levobupivacaine appears attractive as epidural analgesia
because it is less cardio- and neurotoxic than its racemic mixture.
This study evaluated the efficacy and safety of two different
concentrations of levobupivacaine infused epidurally as analgesia for
elderly patients undergoing abdominal surgery.
Methods: This prospective study evaluated the quality of postoperative
analgesia, the six graded physical activity score, the time to
the first passage of flatus, the time to the first oral intake of clear
fluid, and the postoperative hospital stay in patients who received
a continuous thoracic epidural infusion of levobupivacaine at two
different concentrations over a 48 hour period: Group 0.2% (n =
15) or Group 0.25% (n = 15). The incidence of side effects, such
as motor block, hypotension, and bradycardia, was also assessed.
Results: There were no differences with regard to the verbal
numerical rating scale at rest and cough, the total consumption of
rescue analgesia, the incidence of side effects, and the overall
satisfaction. The physical activity scores at postoperative 24 and
48 hours were similar in both groups. However, the time to the first
passage of flatus and time to the first oral intake of clear fluid was
significantly faster in Group 0.25% than in Group 0.2% (P ＜ 0.05).
Conclusions: The continuous thoracic epidural infusion of
levobupivacaine in elderly patients after abdominal surgery at both
0.2% and 0.25% provides a similar quality of analgesia without any
significant motor block. However, increasing the concentration to 0.25% provides a more rapid return of the bowel function but does
not shorten the postoperative hospital stay.

참고자료

· 없음