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ID 113336
Title Alternative
開腹婦人科手術での術後鎮痛における硬膜外間欠投与の有効性
Author
Murakami, Chiaki Tokushima University
Keywords
General anesthesia
Open surgery
PIEB
Content Type
Thesis or Dissertation
Description
Background. It is well known that the programmed intermittent epidural bolus (PIEB) technique effectively provides epidural anesthesia in labor. This randomized double-blind trial compared the postoperative analgesic efficacy of PIEB with that of continuous epidural infusion (CEI) in patients undergoing gynecological surgery under combined general-epidural anesthesia. Methods. Patients undergoing open gynecological surgery under combined general-epidural anesthesia were randomized at a 1 : 1 ratio to receive PIEB or CEI. In the PIEB group, the pump delivered 4mL ropivacaine 0.2% plus fentanyl 2 𝜇g/mL every hour. In the CEI group, the pump delivered the same solution at a rate of 4 mL/h. In both groups, additional 4mL boluses of ropivacaine 0.2% plus fentanyl 2 𝜇g/mL were provided, when necessary, by patient-controlled epidural analgesia after surgery. The primary outcome was the total ropivacaine dose 40 hours after surgery. The secondary outcomes were the number of PCEA boluses and postoperative pain (evaluated on an 11-point numerical rating scale) 3, 24, and 48 hours after surgery. Results. In total, 57 patients were randomized (𝑛 = 28 and 29 in the PIEB and CEI groups, resp.). The two groups differ significantly in terms of the total ropivacaine dose 40 hours after surgery (mean (standard deviation): 155.38 (4.55) versus 159.73 (7.87) mL, 𝑃 = 0.016). Compared to the CEI group, the PIEB group had significantly lower numerical rating scale scores 3 hours (median [lower–upper quartiles]: 0 [0–0.5] versus 3 [0–5.5], 𝑃 = 0.002), 24 hours (1 [0–2] versus 3 [1–4], 𝑃 = 0.003), and 48 hours (1 [0–2] versus 2 [2–3.5], 𝑃 = 0.002) after surgery. Conclusion. PIEB was better than CEI in terms of providing postoperative analgesia after open gynecological surgery under combined general-epidural anesthesia.
Journal Title
BioMed Research International
ISSN
23146133
23146141
Publisher
Hindawi
Volume
2018
Start Page
6297247
Published Date
2018-05-15
Remark
内容要旨・審査要旨・論文本文の公開
本論文は, 著者Shiho Satomiの学位論文として提出され, 学位審査・授与の対象となっている。
Rights
Copyright © 2018 Shiho Satomi et al. This is an open access article distributed under the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/ ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
EDB ID
DOI (Published Version)
URL ( Publisher's Version )
FullText File
language
eng
TextVersion
ETD
MEXT report number
甲第3250号
Diploma Number
甲医第1399号
Granted Date
2019-03-22
Degree Name
Doctor of Medical Science
Grantor
Tokushima University
departments
University Hospital
Medical Sciences