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논문KCI 등재

로피바카인 경막외 마취 시 케타민첨가 용량에 따른 마취시간의 연장

Dose-Related Prolongation of Ropivacaine Epidural Anesthesia by Epidural Ketamine

김용신|김기현|김대우|최진우|전연수|강유진|인장혁|주진덕|임용걸
대한통증학회 (The Korean Pain Society)|2005.06|The Korean Journal of Pain|제18권 제1호|pp. 39-42

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Abstract

Background: Besides its general anesthetic effect, ketamine interacts with sodium channels in a local anesthetic-like fashion, including the sharing of binding sites with those commonly used by clinical local anesthetics. This study evaluated the dose related effects of ketamine during epidural anesthesia with 0.5% ropivacaine. Methods: Sixty ASA physical status I-II patients, scheduled for minor elective surgery under epidural anesthesia using 0.5% ropivacaine, were randomly divided into three groups (n = 20 each). The patients initially received either 0.5% ropivacaine (group 1), ketamine (0.1 mg/kg) in addition to the epidural 0.5% ropivacaine (group 2) or ketamine (0.2 mg/kg) in addition to the epidural 0.5% ropivacaine (group 3). The regression of sensory block was assessed by transcutaneous electric stimulation (TES), equivalent to a surgical incision. Motor block was assessed using the Modified Bromage's scale. Episodes of bradycardia, hypotension and sedation were also recorded. Results: There were no significant differences among the three groups in the maximal levels of sensory block or the times taken for these levels to be reached. The mean times for the block to regress to two and four segments below the maximal level were significantly prolonged by epidural ketamine. Conclusions: Epidural ketamine prolongs the duration of ropivacaine epidural anesthesia. These results suggest that ketamine has local anesthetic-like actions.

참고문헌 (25)

  1. "Intrathecal ketamine reduces morphine requirements in patients with terminal cancer pain", 43, pp.379~83 (1996)
  2. "Low-dose ketamine and midazolam as an adjuvant to iv morphine for control of pain in cancer terminal life care", 16, pp.79~83 (2003)
  3. "Blockade of voltage-operated neuronal and skeletal muscle sodium channels by S", 96, pp.1019~26 (2003)
  4. "Ketamine blockade of voltage-gated sodium channels Evidence for a shared receptor site with local anesthetics", 95, pp.1406~13 (2001)
  5. "Ketamine-its pharmacology and therapeutic uses", 56, pp.119~36 (1982)
  6. "Use and efficacy of low dose ketamine in management of acute postoperative pain", 82, pp.111~25 (1999)
  7. "relief from chronic pain through actions at the NMDA receptor", 68, pp.435~6 (1996)
  8. "The induction and maintenance of central sensitization is dependant on the N-methyl-D-aspartic acid receptor activation implication for the treatment of post-injury pain hypersensitivity states", pp.293~9
  9. "Epidural ketamine for control of postoperative pain", 64, pp.1161~2 (1985)
  10. "A double-blind comparison epidural ketamine and diamorphine for postoperative analgesia", 44, pp.555~8 (1989)
  11. "Intrathecal ketamine for war surgery:a preliminary study under field conditions", 39, pp.1023~8 (1984)
  12. "Blocking mechanism of ketamine and its enantiomers in enzymatically demyelinated peripheral nerve as revealed by single channel experiments", 86, pp.394~404 (1997)
  13. "Preemptive intrathecal ketamine delays mechanical hyperalgesia in the neuropathic rat", 86, pp.557~60 (1997)
  14. "-ketamine reduces postoperative pain when applied with ropivacaine in epidural anesthesia for total knee arthroplasty", 92, pp.1290~5 (2001)
  15. "Cardiotoxicity of ropivacaine:a new amide local anesthetic agent", 33, pp.93~8 (1989)
  16. "Comparison of extradural ropivacaine and bupivacaine", 66, pp.31~7 (1991)
  17. "A double-blind comparison of ropivacaine 0", 43, pp.442~9 (1996)
  18. "Epidural analgesia with local anesthetics after abdominal surgery Earlier motor recovery with 0", 88, pp.128~33 (1999)
  19. "Dose-related prolongation of tetracaine spinal anesthesia by oral clonidine in humans", 79, pp.1121~5 (1994)
  20. "Ketamine enhances local anesthetic and analgesic effects of bupivacaine by peripheral mechanism:a study in postoperative patients", 215, pp.5~8 (1996)
  21. "Oral clonidine prolongs lidocaine spinal anesthesia in human volunteers", 82, pp.1353~9 (1995)
  22. "Long-term subcutaneous infusion of midazolam for refractory delirium in terminal breast cancer", 89, pp.1101~3 (1996)
  23. "The NMDA receptor antagonist ketamine abolishes neuropathic pain after epidural administration in a clinical case", 75, pp.391~4 (1998)
  24. "Evaluation of the safety and efficacy of epidural ketamine combined with morphine for postoperative analgesia in major upper abdominal surgery", 13, pp.339~44 (2001)
  25. "The effect of transdermal nitroglycerin on spinal S -ketamine anti-nociception following orthopedic surgery", 13, pp.576~81 (2001)

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