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Efficacy of Intrathecal Morphine Combined with Intravenous Analgesia versus Thoracic Epidural Analgesia after Gastrectomy

DC FieldValueLanguage
dc.contributor.author구본녀-
dc.contributor.author길혜금-
dc.contributor.author노성훈-
dc.contributor.author박진하-
dc.contributor.author이재훈-
dc.contributor.author최승호-
dc.date.accessioned2015-01-06T16:51:57Z-
dc.date.available2015-01-06T16:51:57Z-
dc.date.issued2014-
dc.identifier.issn0513-5796-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/98919-
dc.description.abstractPURPOSE: Epidural analgesia has been the preferred analgesic technique after major abdominal surgery. On the other hand, the combined use of intrathecal morphine (ITM) and intravenous patient controlled analgesia (IVPCA) has been shown to be a viable alternative approach for analgesia. We hypothesized that ITM combined with IVPCA is as effective as patient controlled thoracic epidural analgesia (PCTEA) with respect to postoperative pain control after conventional open gastrectomy. MATERIALS AND METHODS: Sixty-four patients undergoing conventional open gastrectomy due to gastric cancer were randomly allocated into the intrathecal morphine combined with intravenous patient-controlled analgesia (IT) group or patient-controlled thoracic epidural analgesia (EP) group. The IT group received preoperative 0.3 mg of ITM, followed by postoperative IVPCA. The EP group preoperatively underwent epidural catheterization, followed by postoperative PCTEA. Visual analog scale (VAS) scores were assessed until 48 hrs after surgery. Adverse effects related to analgesia, profiles associated with recovery from surgery, and postoperative complications within 30 days after surgery were also evaluated. RESULTS: This study failed to demonstrate the non-inferiority of ITM-IVPCA (n=29) to PCTEA (n=30) with respect to VAS 24 hrs after surgery. Furthermore, the IT group consumed more fentanyl than the EP group did (1247.2±263.7 μg vs. 1048.9±71.7 μg, p<0.001). The IT group took a longer time to ambulate than the EP group (p=0.021) and had higher incidences of postoperative ileus (p=0.012) and pulmonary complications (p=0.05) compared with the EP group. CONCLUSION: ITM-IVPCA is not as effective as PCTEA in patients undergoing gastrectomy, with respect to pain control, ambulation, postoperative ileus and pulmonary complications.-
dc.description.statementOfResponsibilityopen-
dc.format.extent1106~1115-
dc.relation.isPartOfYONSEI MEDICAL JOURNAL-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/2.0/kr/-
dc.subject.MESHAdult-
dc.subject.MESHAnalgesia, Epidural/methods*-
dc.subject.MESHAnalgesia, Patient-Controlled/methods-
dc.subject.MESHAnalgesics, Opioid/administration & dosage-
dc.subject.MESHAnalgesics, Opioid/therapeutic use-
dc.subject.MESHFemale-
dc.subject.MESHGastrectomy/methods*-
dc.subject.MESHHumans-
dc.subject.MESHMale-
dc.subject.MESHMiddle Aged-
dc.subject.MESHMorphine/administration & dosage*-
dc.subject.MESHMorphine/therapeutic use*-
dc.subject.MESHPain Management/methods-
dc.subject.MESHPain, Postoperative/drug therapy*-
dc.titleEfficacy of Intrathecal Morphine Combined with Intravenous Analgesia versus Thoracic Epidural Analgesia after Gastrectomy-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Anesthesiology (마취통증의학)-
dc.contributor.googleauthorJae Hoon Lee-
dc.contributor.googleauthorJin Ha Park-
dc.contributor.googleauthorHae Keum Kil-
dc.contributor.googleauthorSeung Ho Choi-
dc.contributor.googleauthorSung Hoon Noh-
dc.contributor.googleauthorBon-Nyeo Koo-
dc.identifier.doi10.3349/ymj.2014.55.4.1106-
dc.admin.authorfalse-
dc.admin.mappingfalse-
dc.contributor.localIdA00193-
dc.contributor.localIdA00283-
dc.contributor.localIdA01281-
dc.contributor.localIdA01704-
dc.contributor.localIdA03092-
dc.contributor.localIdA04101-
dc.relation.journalcodeJ02813-
dc.identifier.eissn1976-2437-
dc.identifier.pmid24954344-
dc.subject.keywordAnalgesia-
dc.subject.keywordepidural-
dc.subject.keywordgastrectomy-
dc.subject.keywordintrathecal-
dc.subject.keywordopioid-
dc.subject.keywordpostoperative pain-
dc.contributor.alternativeNameKu, Bon Nyo-
dc.contributor.alternativeNameKil, Hae Keum-
dc.contributor.alternativeNameNoh, Sung Hoon-
dc.contributor.alternativeNamePark, Jin Ha-
dc.contributor.alternativeNameLee, Jae Hoon-
dc.contributor.alternativeNameChoi, Seung Ho-
dc.contributor.affiliatedAuthorKu, Bon Nyo-
dc.contributor.affiliatedAuthorKil, Hae Keum-
dc.contributor.affiliatedAuthorNoh, Sung Hoon-
dc.contributor.affiliatedAuthorPark, Jin Ha-
dc.contributor.affiliatedAuthorLee, Jae Hoon-
dc.contributor.affiliatedAuthorChoi, Seung Ho-
dc.citation.volume55-
dc.citation.number4-
dc.citation.startPage1106-
dc.citation.endPage1115-
dc.identifier.bibliographicCitationYONSEI MEDICAL JOURNAL, Vol.55(4) : 1106-1115, 2014-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers

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