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KMID : 0356919930260030549
Korean Journal of Anesthesiology
1993 Volume.26 No. 3 p.549 ~ p.558
Comparison of Epidural Buprenorphine and Morphine for Postoperative Pain Management in Gynecologic Lower Abdominal Surgery
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±èÀçȯ/ÀÓÇýÀÚ/亴±¹/½ÅÁ¤¼ø/À强ȣ
Abstract
In a double-blind randomized study of five groups of fifty patients scheduled for gynecologic lower abdominal surgery the analgesic efficacy and side effects of epidural buprenorphine were tested and compared to epidural morphine. Single epidural
injection of 0.15mg of buprenorphine in group B 0.15, 0.30mg of buprenorphine in group B 0.3, 0.45mg of buprenorphine in group B 0.45, 3mg of morphine in group M 3 or 6mg o morphine in group M 6 mixed with 10ml of normal saline was done when the
patients complained of postoperative pain after general anesthesia with enflurane-N2O-O2
@ES The results were as follows;
@EN 1) The onset of analgesia was the most rapid in group B 0.45(20.7¡¾3.2 minutes), and appeared as following order: group M 6(29.3¡¾14.3 minutes), group M 3(37.5¡¾6.7 minutes), group B 0.3(39.3¡¾87) minutes), and group B 0.15(60.7¡¾20.2
minutes).
2) Additional requirement of analgesics during first 24 hours after epidural injection was more frequent in group B 0.15(70%) than in any other four groups.
3) The lowest pain score during 24 hours after epidural injection was the lowest I group M 6(1.6¡¾0.5) and group B 0.45(1.8¡¾0.4) and the increasing order of the lowest pain score were as follows; 2.2¡¾0.4 in group M 3, 2.3¡¾0.5 in group B 0.3
and
2.6¡¾0.5 I group B 0.15.
4) The pain score measured 24 hours after epidural injection was significantly lower in group B 0.45(2.0¡¾0.0) than in any other four groups.
5) Subjective rating of well-being for first 24 hours following epidural injection was better in group B 0.45(good in 60% of patients) than in group M 6(god in 10% of patients).
6) Subjective rating of sleep at the first postoperative night showed no significant differences among five groups.
7) Disturbance of micturition after removal of catheter was noted in group B 0.45 and group M 6(30% each) and spontaneous urination after removal of catheter was significantly delayed in group B 0.45(9.1¡¾10.2 hours) and in group M 6(7.2¡¾7.8
hours)
comparing to other three groups.
8) Pruritus was noted only the groups with epidural morphine(in group M 3 & M 6;70% each) and there was no statistical difference between group M 3 and group M 6.
9) The frequency of nausea or vomiting was the lowest in group B 0.45(30%) and the highest in group M 3(90%), and no significant differences were noted among other three groups.
10) Dizziness was noted in group B 0.45 and in group M 6(30% each), but there was no statistical significances among five groups.
11) No signs of respiratory depression were noted.
KEYWORD
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