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슬관절 치환술 후 Fentanyl을 이용한 정맥 내 환자조절진통시 Granisetron과 Ramosetron이 오심과 구토에 미치는 효과

The Effect of the Granisetron and Ramosetron on the Prevention of Postoperative Nausea and Vomiting during Intravenous Patient Controlled Analgesia with Fentanyl after Total Knee Replacement Surgery

양홍석|함경돈|황병문|임정길
대한통증학회 (The Korean Pain Society)|2004.12|The Korean Journal of Pain|제17권 제2호|pp. 23-23

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Abstract

Background: Nausea and vomiting are one of the most distressing side effects in patient controlled analgesia using opioids. Both granisetron and ramosetron, selective 5-hydroxytryptamine type 3 receptor antagonists, were studied for the prevention of the postoperative nausea and vomiting (PONV) that may occur during intravenous patient controlled analgesia (IV-PCA) using fentanyl and ketorolac. Methods: Ninety patients receiving total knee replacement surgery under isoflurane anesthesia were randomly allocated to one of three groups. Each group was administered one of the aforementioned drugs mixed with their PCA solutions; saline, granisetron 3 mg or ramosetron 0.3 mg, respectively. The postoperative pain was controlled by IV-PCA, with fentanyl 20μg/kg and ketorolac 3 mg/kg in normal saline (total volume; 100 ml, basal rate; 1.5 ml/h, volume of bolus doses; 1 ml, lockout interval; 10 min). The pain scores, frequencies of rescue analgesics requirement, incidence of vomiting, cumulated doses of fentanyl, incidence of severe nausea requiring additional antiemetics and the severity scores for nausea were checked up to second postoperative day by a blind observer. Results: The severity score for postoperative nausea was low in the granisetron and ramosetron groups compared with saline control group (P ＜ 0.05). There were no significant differences between the three groups in their pain scores, frequencies of rescue analgesics requirement, incidence of vomiting, cumulated doses of fentanyl and incidence of severe nausea requiring additional antiemetics. Conclusions: These results suggest that the incidence of severe PONV was not low, but the severity of postoperative nausea can be lowered by granisetron and ramosetron during IV-PCA with fentanyl and ketorolac.

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