위절제술 후 경막외 통증자가조절에 사용한 Butorphanol과 Fentanyl의 비교

Abstract

Background: Epidural butorphanol produces effective analgesia with fewer side effects than morphine in obstetric patients. The analgesic efficacy and side effects of epidural butorphanol were compared with epidural fentanyl for patient-controlled epidural analgesia (PCEA) after gastrectomy. Methods: After obtaining patient consent, 75 patients undergoing elective gastrectomy were randomly allocated to epidural butorphanol and epidural fentanyl groups. An epidural catheter was introduced at the T7-8 or T9-10 intervertebral spaces before operation. General anesthesia was maintained with N2O / O2, enflurane and vecuronium. Postop-erative analgesia was provided using a PCEA with either fentanyl 5μg/ml or butorphanol 50μg/ml in a 0.05% bupivacaine solution. When patients first required analgesics after complete recovery of conscious-ness from general anesthesia, a bolus of 5 ml of PCEA solution was initially administered in both groups. The PCEA was set to deliver a bolus of 2 ml, with a lockout interval of 10 min, and no basal infusion. PCEA consumption, pain intensity using a visual analog score (VAS), patient's satisfaction to PCEA, and side effects were evaluated. Results: No significant difference in PCEA consumption, VAS pain score, or patient's satisfaction to PCEA was found between the two groups. The incidence of pruritus in the butorphanol group was less than that in the fentanyl group (P ＜ 0.05). Conclusions: PCEA with butorphanol provided similar postoperative analgesia with less pruritus than fentanyl in gastrectomized patients.