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항문 주위 수술후 통증관리를 위한 지주막하강내 Morphine의 유효량
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  • 항문 주위 수술후 통증관리를 위한 지주막하강내 Morphine의 유효량
저자명
원종인,조인찬,박영철,Won. Jong-In,Cho. In-Chan,Park. Young-Chul
간행물명
大韓痛症學會誌
권/호정보
1999년|12권 1호|pp.59-63 (5 pages)
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이 논문은 한국과학기술정보연구원과 논문 연계를 통해 무료로 제공되는 원문입니다.
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기타언어초록

Background: Contraction of anal sphincter muscle produces severe pain in perianal surgery postoperatively. Recent reports have indicated that effective and prolonged pain relief can be obtained by the injection of small doses of morphine into the subarachnoid space. We attempted to use this technique for perianal surgery and investigated postoperative pain control and its side effects. Methods: Forty five patients scheduled for hemorrhoidectomy and anal fistulectomy were studied to determine the minimal effective dose of intrathecal morphine for postoperative analgesia. In order to control the pain, 7 mg of 0.5% hyperbaric bupivacaine with 0.05 mg (group I), 0.1 mg (group II) and 0.15 mg (group III) of morphine hydrochloride was injected with a 25 gauge spinal needle into the subarachnoid space. We estimated the duration of analgesia until the pain score attained to above 3 in 10 cm VAS (visual analogue scale) and incidence of itching, nausea and vomiting by percentage, headache, backpain and respiratory depression by positive and negative. We also checked the time of self-voiding. Results: The mean time of analgesia was $10.3{pm}1.54$, $19.7{pm}2.22$ and $20.3{pm}2.29$ hours in group I, II and III respectively. Urinary retention of group I, II and III after block persisted for an average of $20.3{pm}2.31$, $21.2{pm}2.51$ and $23.3{pm}3.74$ hours. Nausea and vomiting were observed 33%, 53%, 67% and itching was observed 53%, 67%, 80% in group I, II and III respectively and respiratory depression did not occur in all groups. Conclusions: It is not necessary to use more than 0.1mg of intrathecal morphine in perianal surgery because analgesia is not prolonged and side effects are increased.