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경막외 마취를 받은 제왕절개 환자의 통증관리시 Ketamine의 경막외강 투여시기에 따른 진통효과

Other Titles
 The Effects of Preoperative or Postperitoneal Closure Epidural Ketamine on Epidural Anesthesia and Analgesia for Obstetric Patients 
Authors
 홍정연  ;  이윤우 
Citation
 Journal of Korean Society of Anesthesiologist (대한마취과학회지), Vol.37(2) : 276-282, 1999 
Journal Title
 Journal of Korean Society of Anesthesiologist (대한마취과학회지) 
ISSN
 0302-5780 
Issue Date
1999
Keywords
Analgesics ; ketamine ; morphine ; Pain ; postoperative
Abstract
BACKGROUND : The NMDA receptor mediates wind-up and long-term potentiation in the responses of cells to prolonged stimuli; thus we postulated that the induction and maintenance of sensitization would be affected by the timing of epidural ketamine administration under epidural anesthesia. METHODS : Sixty patients undergoing elective cesarian section were randomly and equally assigned to one of three groups. 20 ml of 2% lidocaine and 2 mg morphine with epinephrine was injected to all patients epidurally through an indwelling catheter inserted at the L2-3 interspace. Before surgical incision, the patients in group 1 were given 3 ml saline, while the patients in group 2 were given 30 mg ketamine. In group 3, patients were injected with 30 mg ketamine after peritoneal closure. An additional 2 mg morphine was injected into all patients 24 h after surgery. The analgesic effects were assessed and side effects were also evaluated. RESULTS : VAS of group 3 at 3 24 h was lower than in the group 1, and at 6 24 h it was lower than in the group 2. The number of patients using additional analgesics in group 3 was lower than in the other groups. The incidence of nausea and vomiting was higher in the group 1 than in the other groups, but dizzness was higher in the groups 2 and 3 than in the control group. CONCLUSIONS : Preoperative administration of epidural ketamine is less effective in reducing postoperative pain than when given after peritoneal closure, especially under epidural anesthesia with local anesthetics.
Files in This Item:
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Lee, Youn Woo(이윤우)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/174398
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