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제왕절개술후 자가진통법을 이용한 정맥내 Nalbuphine은 경막외 Morphine과 Bupivacaine 혼합제를 대치할 수 있나?

Other Titles
 Intravenous Patient-Controlled Analgesia with Nalbuphine: Could be an Alternative to Epidural Patient-Controlled Analgesia with Morphine-Bupivacaine for Pain Relief after Cesarean Delivery? 
Authors
 이종석  ;  이윤우  ;  윤덕미  ;  남용택  ;  송근호 
Citation
 Korean Journal of Pain (대한통증학회지), Vol.10(1) : 34-41, 1997 
Journal Title
 Korean Journal of Pain (대한통증학회지) 
ISSN
 1226-2579 
Issue Date
1997
Abstract
Background: Patient-controlled analgesia(PCA) is a safe and effective technique for providing postoperative pain relief. Studies that compare epidural vs intravenous routes of opiate administration show conflicting results. We designed a prospective, randomized, controlled study to evaluate the safety and efficacy of epidural(EPI-PCA) morphine-bupivacaine versus intravenous (IV-PCA) nalbuphine when administered with a PCA system. Methods: Forty healthy women were randomly assigned to receive an epidural bolus of morphine 3 mg and 0.5% bupivacaine 10 ml, followed by a EPI-PCA with 0.01% morphine and 0.143% bupivacane (basal infusion 1 ml/hr, bolus 1 ml, lock-out interval 30 min) or intravenous bolus of nalbuphine 0.1 mg/kg followed by a IV-PCA with nalbuphine(basal infusion 1 mg/hr, bolus 1 mg/1ml, lock-out interval 20 min) for pain relief after cesarean delivery. This study was conducted for 2 days after cesarean section to compare the analgesic efficacy, side effects, patient satisfaction either as EPI-PCA or as IV-PCA. Results: EPI-PCA group had significant lower visual analog pain scale(VAS) at immediate postoperative period, whereas no significant difference was observed when pain was assessed at other time sequence. Urinary retention and pruritus were more frequent with EPI-PCA group, although the incidence of other side effects were the same. Conclusions: Although EPI-PCA with morphine-bupivacaine was of significantly lower VAS at immediate postoperative period, IV-PCA with nalbuphine is a safe and effective alternative to EPI-PCA with morphine-bupivacaine for providing pain relief after cesarean delivery. Further studies about IV-PCA with nalbuphine are needed to control the immediate postoperative pain and to further improve effective pain management.
Files in This Item:
T199700925.pdf Download
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Nam, Yong Taek(남용택)
Yoon, Duck Mi(윤덕미)
Lee, Youn Woo(이윤우)
Lee, Jong Seok(이종석) ORCID logo https://orcid.org/0000-0002-7945-2530
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/177927
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