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Original Article

수술 후 자가통증조절장치 사용 환자에서 propacetamol과 fentanyl 복합제 및 fentanyl 단일제제의 효과 비교

원문정보

Comparison of Propacetamol plus Fentanyl and Fentanyl alone with Patient Controlled Analgesia after Total Knee Arthroplasty

김민형, 정효근, 박소현, 이정연

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초록

영어

Objective: Opioid analgesics, for postoperative pain management, are an indispensable group of medication; however, they also have a variety of adverse drug reactions (ADR). Multimodal methods, combining non-opioid analgesics with opioid analgesics, have been investigated to increase the effects of analgesics and reduce ADR with opioid-sparing effects. The purpose of this study was to compare the effects of patient-controlled analgesia (PCA) with fentanyl alone, and PCA with fentanyl and intravenous (i.v.) propacetamol to determine the effects of pain control, cumulative opioid usage, and opioid ADR. Methods: The subjects were patients who underwent total knee arthroplasty at the Seoul Veterans hospital from January 1, 2015 to December 31, 2016. The study period was from postoperative day 0 (POD0) to day 3 (POD3), and the retrospective study was conducted using electronic medical records. Results: Pain severity was significantly low at POD1 (p = 0.017), POD2 (p = 0.003), and POD3 (p = 0.002) in the multimodal group. The fentanyl only group frequently reported both moderate and severe pain at a statistically significant level. This was consistent with the analysis of the pro re nata (PRN) intramuscular analgesia usage at the time of numerical rating scale (NRS) 4 and above. The opioid-sparing effect confirmed that the average opioid dose equivalent to i.v. morphine dose was 9.4 mg more than that used for the multimodal group in the fentanyl only group. The ADRs and length of stay between the two groups were not statistically different. Conclusion: The results of this study suggest that the combination therapy of fentanyl and i.v. propacetamol is superior to fentanyl monotherapy.

목차

ABSTRACT
 연구 방법
  연구대상
  자료수집 및 연구방법
  통계학적 처리
  윤리심의위원회 및 이해 충돌
 연구 결과
  연구대상의 특성
  Numerical rating scale (NRS) 변화
  돌발 통증
  진통제 사용 양상
  부작용
  구역, 구토 부작용과 위험인자
  재원 기간
 고찰 및 결론
 참고문헌

저자정보

  • 김민형 Minhyung Kim. 이화여자대학교 임상보건융합대학원, 중앙보훈병원 약제실
  • 정효근 Hyokeun Jeong. 중앙보훈병원 약제실
  • 박소현 Sohyun Park. 이화여자대학교 대학원 생명약학부
  • 이정연 Sandy Jeong Rhie. 이화여자대학교 임상보건융합대학원, 이화여자대학교 대학원 생명약학부, 이화여자대학교 대학원 약학대학

참고문헌

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