성인 편도수술 환자에서 정맥 내 자가 통증 조절법의 유용성
Availability of Intravenous Patients-Controlled Analgesia for Adult Tonsillectomy Patients
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Background：Post-tonsillectomy pain control is clinically important in otolaryngologic field. The aim of this study is to evaluate the efficacy and the safety of intravenous patients-controlled analgesia (IV PCA) after tonsillectomy in adults compare to non steroidal anti inflammatory drugs (NSAIDs). We also evaluate sexual differences in severity of postoperative pain and in response toward analgesics. Methods：In total, 40 patients underwent tonsillectomy due to frequent tonsillitis were enrolled. After subdivide patients into IV PCA group (Remifentanil 1 mg, 10 men and 10 women) and NASIDs group (Diclofenac sodium 75 mg, 10 men and 10 women), we compare postoperative pain during postoperative 3 days. Results：IV PCA group had significantly less pain at postoperative first, second and third day compared to the group using the NSAIDs (p＜0.05). In IV PCA group, postoperative pain decreased more rapidly than NSAIDs group. Women complained more severe pain compared to men in both groups (p＜0.05). Conclusions：IV PCA is more effective to control pain compared to NSAIDs in adult tonsillectomy patients. Women felt more intense pain than men. It is important find a suitable postoperative pain control method.
Abstract
Background：Post-tonsillectomy pain control is clinically important in otolaryngologic field. The aim of this study is to evaluate the efficacy and the safety of intravenous patients-controlled analgesia (IV PCA) after tonsillectomy in adults compare to non steroidal anti inflammatory drugs (NSAIDs). We also evaluate sexual differences in severity of postoperative pain and in response toward analgesics. Methods：In total, 40 patients underwent tonsillectomy due to frequent tonsillitis were enrolled. After subdivide patients into IV PCA group (Remifentanil 1 mg, 10 men and 10 women) and NASIDs group (Diclofenac sodium 75 mg, 10 men and 10 women), we compare postoperative pain during postoperative 3 days. Results：IV PCA group had significantly less pain at postoperative first, second and third day compared to the group using the NSAIDs (p＜0.05). In IV PCA group, postoperative pain decreased more rapidly than NSAIDs group. Women complained more severe pain compared to men in both groups (p＜0.05). Conclusions：IV PCA is more effective to control pain compared to NSAIDs in adult tonsillectomy patients. Women felt more intense pain than men. It is important find a suitable postoperative pain control method.
참고문헌 (17)
- 김남국, "편도절제술의 4가지 기법에 대한 비교", 대한이비인후과학회지 두경부외과학, 56(12), pp.773~777 (2013), 대한이비인후과학회[DOI]
- 김병국, "Coblation 편도절제술과 전통적 박리 편도절제술의 비교", 대한이비인후과학회지 두경부외과학, 50(7), pp.612~615 (2007), 대한이비인후과학회
- Adriaenssens G, "Postoperative analgesia with i.v. patient-controlled morphine: effect of adding ketamine", Br J Anaesth, 83(3), pp.393~396 (1999)
- Engelhardt T, "Tramadol for pain relief in children undergoing tonsillectomy: a comparison with morphine", Paediatr Anaesth, 13(3), pp.249~252 (2003)
- Pendeville PE, "Double-blind randomized study of tramadol vs. paracetamol in analgesia after day-case tonsillectomy in children", Eur J Anaesthesiol, 17(9), pp.576~582 (2000)
- Sinatra R., "The fentanyl HCl patient-controlled transdermal system (PCTS): an alternative to intravenous patientcontrolled analgesia in the postoperative setting", Clin Pharmacokinet, 44(1), pp.1~6 (2005)
- Rodgers BM, "Stergios D, Newman BM. Patientcontrolled analgesia in pediatric surgery", J Pediatr Surg, 23(3), pp.259~262 (1988)
- Berde CB, "Patient-controlled analgesia in children and adolescents: a randomized, prospective comparison with intramuscular administration of morphine for postoperative analgesia", J Pediatr, 118(3), pp.460~466 (1991)
- Ballantyne JC, "Postoperative patient-controlled analgesia:meta-analyses of initial randomized control trials", J Clin Anesth, 5(3), pp.182~193 (1993)
- Viscusi ER, "Patient-controlled transdermal fentanyl hydrochloride vs intravenous morphine pump for postoperative pain: a randomized controlled trial", JAMA, 291(11), pp.1333~1341 (2004)
- 박도회, "편도절제술 후 통증에 대한 섬유소 응고제 국소 도포의 효과", 대한이비인후과학회지 두경부외과학, 52(7), pp.591~593 (2009), 대한이비인후과학회
- Panarese A, "Early post-operative morbidity following tonsillectomy in children: implications for day surgery", J Laryngol Otol, 113(12), pp.1089~1091 (1999)
- Ang C, "Tropisetron reduces vomiting after tonsillectomy in children", Br J Anaesth, 80(6), pp.761~763 (1998)
- Sutherland CJ, "A comparison of intramuscular tenoxicam with intramuscular morphine for pain relief following tonsillectomy in children", PaediatrAnaesth, 8(4), pp.321~324 (1998)
- Gear RW, "Sexual dimorphism in very low dose nalbuphine postoperative analgesia", Neurosci Lett, 339(1), pp.1~4 (2003)
- Butcher BE, "Sex differences in analgesic response to ibuprofen are influenced by expectancy: a randomized, crossover, balanced placebo-designed study", Eur Pain, 16(7), pp.1005~1013 (2012)
- 정광태, "편도절제술 수술 방법에 따른 술 후 통증 비교 : 고식적인 방법, 섬유소 응고제 국소도포와 Coblation 비교 분석", 임상이비인후과, 24(1), pp.56~61 (2013), 대한이비인후과학회 부산,울산,경남 지부회