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임상연구 : 정맥내 자가조절진통이 근이완제를 사용한 환자에서 근력과 호흡능력의 회복에 미치는 영향
김세환 ( Se Hwan Kim ),한옥식 ( Ok Sik Han ),정희숭 ( Hee Soong Jung ),김두식 ( Doo Sik Kim ),류시정 ( Sie Jeong Ryu ),장태호 ( Tae Ho Chang ),김경한 ( Kyung Han Kim ) 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.51 No.2
Background: Residual muscle paralysis after anesthesia is reduced with the advent of intermediate-acting neuromuscular blocking drugs, yet the incidence is as high as about 10 percent. Opioids in patient-controlled analgesia (PCA) may cause respiratory depression and other problems after anesthesia. The purpose of this study is to evaluate the influence of PCA on the SPO2, TOF ratio, head-lift and tongue protrusion during recovery room stay following intraoperative muscle relaxants. Methods: 120 patients aged from 20 to 65 in ASA class I and II were divided into control or PCA groups. All patients received rocuronium (0.9 mg/kg) or atracurium (0.5 mg/kg) for tracheal intubation, and maintenance of relaxation was done with atracurium 0.2 mg/kg/hr during inhalation anesthesia. Reversal of block was done with pyridostigmine 0.15 mg/kg and glycopyrrolate 0.2 mg. SpO2. TOF ratio, 5 see-head lift, tongue protrusion tests were evaluated in the recovery room. Results: IV-PCA did not influence the incidence of residual block, SPO2, TOF ratio during recovery room stay for 20 minutes, but influenced negatively 5 see-head lift test, tongue protrusion test only immediately after arrival at the recovery room. Conclusions: Since IV-PCA decreased the ability to perform head-lift and tongue protrusion early postoperatively, it is recommended that patients with IV-PCA should be carefully managed against the risk of aspiration or upper respiratory obstruction during their early recovery room stay. (Korean J Anesthesiol 2006; 51: 167~73)
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