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논문 기본 정보

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학술저널
저자정보
Park Insun (Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.) Hong Seukyoung (Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital) Kim Su Yeon (Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital) 황정원 (서울대학교) 도상환 (독립연구자) 나효석 (분당서울대학교병원)
저널정보
대한마취통증의학회(구 대한마취과학회) Korean Journal of Anesthesiology Korean Journal of Anesthesiology Vol.77 No.1
발행연도
2024.2
수록면
77 - 84 (8page)
DOI
10.4097/kja.23217

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Background: A combination of opioids and adjunctive drugs can be used for intravenous patient-controlled analgesia (PCA) to minimize opioid-related side effects. We investigated whether two different analgesics administered separately via a dual-chamber PCA have fewer side effects with adequate analgesia than a single fentanyl PCA in gynecologic pelviscopic surgery.Methods: This prospective, double-blind, randomized, and controlled study included 68 patients who underwent pelviscopic gynecological surgery. Patients were allocated to either the dual (ketorolac and fentanyl delivered by a dual-chamber PCA) or the single (fentanyl alone) group. Postoperative nausea and vomiting (PONV) and analgesic quality were compared between the two groups at 2, 6, 12, and 24 h postoperatively.Results: The dual group showed a significantly lower incidence of PONV during postoperative 2–6 h (P = 0.011) and 6–12 h (P = 0.009). Finally, only two patients (5.7%) in the dual group and 18 (54.5%) in the single group experienced PONV during the entire postoperative 24 h and could not maintain intravenous PCA (odds ratio: 0.056, 95% CI [0.007, 0.229], P < 0.001). Despite the administration of less fentanyl via intravenous PCA during the postoperative 24 h in the dual group than in the single group (66.0 ± 77.8 vs. 383.6 ± 70.1 μg, P < 0.001), postoperative pain had no significant intergroup difference.Conclusions: Two different analgesics, continuous ketorolac and intermittent fentanyl bolus, administered via dual-chamber intravenous PCA, showed fewer side effects with adequate analgesia than conventional intravenous fentanyl PCA in gynecologic patients undergoing pelviscopic surgery.

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