• 검색 결과가 없습니다.

Intravenous PCA with fentanyl 10 µg/kg, ketorolac 3 mg/kg and

ondansetron 12 mg causes minimal side effects such as PONV and

dizziness in thyroid surgery.

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< ABSTRACT(IN KOREAN)>

갑상선절제술 후 fentanyl과 ketorolac을 이용한 정맥 자가통증조절시 적절한 용량

<지도교수 김 기 준>

연세대학교 대학원 의학과

김 소 연

갑상선 절제술을 받은 환자들은 술 후 아편양제제가 필요할 정

도의 중증도의 통증을 경험하게 되며 다수에서 구역 또는 구토

를 경험하게 된다. 아편양제제를 혼합한 정맥 자가통증조절은

술 후 통증 조절에 효과적이나 구역 또는 구토를 유발할 수 있

다. 본 연구의 목적은 갑상선 수술 환자를 대상으로 fentanyl과

ketorolac의 용량 비율을 변화시켜 통증조절의 정도와 구역, 구

토 등의 부작용을 비교함으로써 갑상선 수술에 적절한 정맥 자

가통증조절의 용량을 조사하는 데 있다. 갑상선 절제술을 받는

135명의 환자를 세 군으로 무작위 분류하여 I군(n=45)은

fentanyl 15 μg/kg + ondansetron 12 mg, II군(n=45)은 fentanyl 12.5 μg/kg + ketorolac 1.5 mg/kg + ondansetron 12 mg, III군 (n=45)은 fentanyl 10 μg/kg + ketorolac 3 mg/kg +ondansetr- on 12 mg을 생리식염수와 혼합하여 100 ml 정맥 자가통증조절 장치를 갑상선 조직이 제거된 직후 연결하였다. 기본 투여량 2 ml/hr, 환자 요구량 0.5 ml, 폐쇄 간격 15분으로 정하였다. 술 후 1, 6, 12, 24시간에 통증의 정도와 구역 및 구토, 다른 부작용 등을 평가하였다. 세 군에서 술 후 통증의 정도는 비슷하였다.

그러나 술 후 구역 및 구토는 I군에 비해 II와 III군에서 의미있 게 낮았고(p < 0.05), 어지러움은 I, II군에 비해 III군에서 통계적 으로 의미있게 낮았다(p < 0.05). 결론적으로, 갑상선 수술에서 fentanyl 10 μg/kg, ketorolac 3 mg/kg과 ondansetron 12 mg을 혼합한 정맥 자가통증조절을 사용하면 술 후 구역, 구토 및 어 지러움을 최소화 할 수 있다.

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핵심되는 말 : fentanyl, ketorolac, 통증, 자가통증조절, 수술 후

구역 구토, 갑상선수술

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