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        술후 통증관리를 위한 경막외 Morphine-Bupivacaine 과 Fentanyl-Bupivacaine 의 비교

        주진철,장진경,오지현,손향초 대한마취과학회 1994 Korean Journal of Anesthesiology Vol.27 No.7

        The fallowing study was performed in 100 patients undergoing gynecologic lower abdominal surgery. Analgesic efficacy, changes in arterial blood pressure and heart rate, and incidence of side effect were observed after epidural injection of the drugs. The patients were devided into two groups (N=50). Group I was given a bolus dose of 1 mg morphine in 10 ml of 0.25% bupivacaine followed by continuous epidural infusion of morphine 0.05 mg/ml in 0.15% bupivacaine at 2 ml/hr. Group II was given a bolus dose of 100 ug fentanyl in 10 ml of 0.25% bupivacaine followed by continuous epidural infusion of fentanyl 5 ug/ml in 0.15% bupivacaine at 2 ml/hr. The results were as follows. 1) The pain score (visual analogue pain scale) measured at postoperation 1 hr was significantly decreased in Group II (1.51±1.0) compared to group I (2.20±1.1). Percentage of patients needed supplemental analgesics within postoperation 20 min was significantly lower in Group II (4%) than Group I (16%). 2) The cardiovascular changes for 2 hrafter epidutal injection were not occurred significant in both groups. 3) The incidence of nausea or vomiting was significantly lower in Group II (8%) than Group I (28%). Pruritus occurred also significantly less often in Group lI (6%) than group I (30%). Urinary retention and respiratory depression were not observed.

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        척추마취시 Morphine 이 Epinephrine 과 Clonidine 작용에 미치는 영향

        박찬주,송현철,오지현,손향초 대한마취과학회 1994 Korean Journal of Anesthesiology Vol.27 No.9

        To evaluate the effect of Morphine during spinal anesthesia with α-adrenergic agonist, we used 0.18 mg of epinephrine, 90 μg of clonidine and 0.3 mg of morphine with 12 mg of T-cain respectively and compared hemodynamic and analgesic effects of each drug. Eighty patients were divided into four groups as follows; Group I (n=20); T-cain with clonidine, Group II (n=20); T-cain with epinephrine, Group III (n=20); T-cain with clonidine and morphine, and Group IV (n=20); T-cain with epinephrine and morphine. The results were as follows; 1) The onset time of analgesia and the time reached to the highest level of sensory loss were most rapid in the epinephrine and morphine group. 2) The duration of analgesia was significantly prolonged in the group of epinephrine and morphine than the group of epinephrine and clonidine. 3) It was more likely complicated in the morphine groups than others but there was no significance. 4) Although the heart rate was gradually decreased over 60 min. after anesthesia, there was no sigficance between the groups. 5) Systolic and diastolic blood pressure were decreased mainly over 30∼45 min. after anesthesia, but there was no significance. In conclusion, epinephrine can be sustituted for clonidine because analgesic duration was not significantly changed, and the duration of analgesia was prolonged by morphine.

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