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임상연구 : 마취 방법이 대장 절제술 후 장운동에 미치는 영향
이근무 ( Kun Moo Lee ),배우종 ( Jong Woo Bae ),김영환 ( Young Hwan Kim ),임세훈 ( Hoon Se Lim ),이정한 ( Jeong Han Lee ),정순호 ( Soon Ho Cheong ),최영균 ( Young Kyun Choe ),김영재 ( Young Jae Kim ),신치만 ( Chee Mahn Shin ) 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.51 No.6
Background: Gastrointestinal bowel movements are reduced by opioid-based anesthesia. Remifentanil is commonly used as total intravenous anesthesia. This study compared to the effect of various anesthetic methods on gastrointestinal bowel movement after colon surgery. Methods: Ninety patients were allocated randomly into three groups. Thirty patients received intraoperative inhalation anesthesia (desflurane + N2O, Group I), 30 patients received intraoperative total intravenous anesthesia (propofol + remifentanil, Group II), and 30 patients received intraoperative epidural anesthesia (epidural lidocaine + propofol, Group III). All patients received postoperative epidural analgesia with a mixture of ropivacaine and morphine. The time to the first passage of flatus, hospital stay and visual analog pain scale were recorded. Results: There was no significant difference in first passage of flatus among groups (Group I: 92.7 ± 19.6, Group II: 86.9 ± 19.4, Group III: 81.9 ± 12.8 hours, P = 0.063). There were no significant difference in the hospital stay and visual analog scale among the three groups. Conclusions: Total intravenous anesthesia with remifentanil did not reduce the gastrointestinal bowel movements compared with those of inhalation or epidural anesthesia. (Korean J Anesthesiol 2006; 51: 659~62)