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ID 113336
タイトル別表記
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
著者
里見, 志帆 徳島大学大学院医科学教育部(医学専攻) KAKEN研究者をさがす
村上, 千晶 Tokushima University
キーワード
General anesthesia
Open surgery
PIEB
資料タイプ
学位論文
抄録
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.
掲載誌名
BioMed Research International
ISSN
23146133
23146141
出版者
Hindawi
2018
開始ページ
6297247
発行日
2018-05-15
備考
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。
権利情報
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
出版社版DOI
出版社版URL
フルテキストファイル
言語
eng
著者版フラグ
博士論文全文を含む
文科省報告番号
甲第3250号
学位記番号
甲医第1399号
学位授与年月日
2019-03-22
学位名
博士(医学)
学位授与機関
徳島大学
部局
病院
医学系