Hwang, Boo Young
(Department of Anesthesia and Pain Medicine, Biomedical Research Institute, Pusan National University Hospital)
,
Kwon, Jae Young
(Department of Anesthesia and Pain Medicine, Biomedical Research Institute, Pusan National University Hospital)
,
Jeon, So Eun
(Department of Anesthesia and Pain Medicine, Biomedical Research Institute, Pusan National University Hospital)
,
Kim, Eun Soo
(Department of Anesthesia and Pain Medicine, Biomedical Research Institute, Pusan National University Hospital)
,
Kim, Hyae Jin
(Department of Anesthesia and Pain Medicine, Biomedical Research Institute, Pusan National University Hospital)
,
Lee, Hyeon Jeong
(Department of Anesthesia and Pain Medicine, Biomedical Research Institute, Pusan National University Hospital)
,
An, Jihye
(Department of Anesthesia and Pain Medicine, Biomedical Research Institute, Pusan National University Hospital)
Background: Patient-controlled epidural analgesia (PCEA) is known to provide good postoperative analgesia in many types of surgery including laparoscopic surgery. However, no study has compared PCEA with patient-controlled intravascular analgesia (PCIA) in laparoscopic radical prostatectomy (LARP). ...
Background: Patient-controlled epidural analgesia (PCEA) is known to provide good postoperative analgesia in many types of surgery including laparoscopic surgery. However, no study has compared PCEA with patient-controlled intravascular analgesia (PCIA) in laparoscopic radical prostatectomy (LARP). In this study, the efficacy and side effects of PCEA and PCIA after LARP were compared. Methods: Forty patients undergoing LARP were randomly divided into two groups: 1) a PCEA group, treated with 0.2% ropivacaine 3 ml and 0.1 mg morphine in the bolus; and 2) a PCIA group, treated with oxycodone 1 mg and nefopam 1 mg in the bolus. After the operation, a blinded observer assessed estimated blood loss (EBL), added a dose of rocuronium, performed transfusion, and added analgesics. The numeric rating scale (NRS), infused PCA dose, and side effects were assessed at 1, 6, 24, and 48 h. Results: EBL, added rocuronium, and added analgesics in the PCEA group were less than those in the PCIA group. There were no significant differences in side-effects after the operation between the two groups. Patients were more satisfied with PCEA than with PCIA. The NRS and accumulated PCA count were lower in PCEA group. Conclusions: Combined thoracic epidural anesthesia could induce less blood loss during operations. PCEA showed better postoperative analgesia and greater patient satisfaction than PCIA. Thus, PCEA may be a more useful analgesic method than PICA after LARP.
Background: Patient-controlled epidural analgesia (PCEA) is known to provide good postoperative analgesia in many types of surgery including laparoscopic surgery. However, no study has compared PCEA with patient-controlled intravascular analgesia (PCIA) in laparoscopic radical prostatectomy (LARP). In this study, the efficacy and side effects of PCEA and PCIA after LARP were compared. Methods: Forty patients undergoing LARP were randomly divided into two groups: 1) a PCEA group, treated with 0.2% ropivacaine 3 ml and 0.1 mg morphine in the bolus; and 2) a PCIA group, treated with oxycodone 1 mg and nefopam 1 mg in the bolus. After the operation, a blinded observer assessed estimated blood loss (EBL), added a dose of rocuronium, performed transfusion, and added analgesics. The numeric rating scale (NRS), infused PCA dose, and side effects were assessed at 1, 6, 24, and 48 h. Results: EBL, added rocuronium, and added analgesics in the PCEA group were less than those in the PCIA group. There were no significant differences in side-effects after the operation between the two groups. Patients were more satisfied with PCEA than with PCIA. The NRS and accumulated PCA count were lower in PCEA group. Conclusions: Combined thoracic epidural anesthesia could induce less blood loss during operations. PCEA showed better postoperative analgesia and greater patient satisfaction than PCIA. Thus, PCEA may be a more useful analgesic method than PICA after LARP.
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문제 정의
Therefore, it is necessary to investigate which analgesic method is more advantageous for LARP. The objective of this study was to investigate the analgesic effects of PCEA and PCIA on acute postoperative pain in LARP.
제안 방법
3. Numeric rating scale (NRS) of pain intensity and accumulated PCA count at 1, 6, 24 and 48 h after the operation. (A) Numeric rating scale (NRS) of pain intensity at 1, 6, 24 and 48 h after the operation.
대상 데이터
Forty ASA I or II patients aged 45 to 75 years old who were scheduled for LARP were included. Patients who did not qualify for treatment with morphine, nefopam, ropivacaine, oxycodone, or epidural procedures, who could not use the numeric rating scale (NRS), or who had a psychological disorder, chronic pain disorder, renal failure, hepatic failure, or preoperative administration of medications including opioids, antidepressants, gabapentin, pregabalin, and carbamazepine, were excluded.
0 for each group in the preliminary test. We enrolled 40 subjects for this study, to be prepared for a 10% exclusion rate.
데이터처리
Satisfaction scores were also compared using the Chi-square test. Laparoscopic gas insufflation pressure, Ppeak, ETCO2, RR, vital signs, BIS score, TOF, NRS, and accumulated PCA dose were compared using two-way repeated measures ANOVA.
They were compared using the Student’s t-test and Chi-square test.
이론/모형
They were compared using the Student’s t-test and Chi-square test. Anesthetic data of the operation were compared using the Mann-Whitney test. The incidence of side effects was compared using the Chi-square test.
The incidence of side effects was compared using the Chi-square test. Satisfaction scores were also compared using the Chi-square test. Laparoscopic gas insufflation pressure, Ppeak, ETCO2, RR, vital signs, BIS score, TOF, NRS, and accumulated PCA dose were compared using two-way repeated measures ANOVA.
Anesthetic data of the operation were compared using the Mann-Whitney test. The incidence of side effects was compared using the Chi-square test. Satisfaction scores were also compared using the Chi-square test.
성능/효과
In conclusion, PCEA showed a greater effect on postoperative pain relief and patient satisfaction than PCIA. Epidural anesthesia also induced less blood loss during the operation.
In this study, we showed that thoracic epidural anesthesia was more effective by producing less estimated blood loss, and that patients in the PCEA group showed lower NRS scores than those in the PCIA group. PCEA provided better pain management and greater satisfaction to patients than PCIA.
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