경막외강에 Morphine과 동반 투여한 Midazolam의 진통효과

Post-operative Analgesic Effect of Epidural Midazolam Administered with Morphine

  • 양내윤 (가톨릭대학교 의과대학 마취과학교실) ;
  • 문동언 (가톨릭대학교 의과대학 마취과학교실) ;
  • 심재용 (가톨릭대학교 의과대학 마취과학교실) ;
  • 박철주 (가톨릭대학교 의과대학 마취과학교실) ;
  • 권오경 (가톨릭대학교 의과대학 마취과학교실) ;
  • 김대우 (가톨릭대학교 의과대학 마취과학교실) ;
  • 원치환 (성모 통증의원) ;
  • 김선철 (성모 통증의원) ;
  • 채현 (채현 통증크리닉) ;
  • 김욱성 (청솔 통증크리닉)
  • Yang, Nae-Yun (Department of Anesthesiology, College of Medicine, The Catholic University of Korea) ;
  • Moon, Dong-Eon (Department of Anesthesiology, College of Medicine, The Catholic University of Korea) ;
  • Shim, Jae-Yong (Department of Anesthesiology, College of Medicine, The Catholic University of Korea) ;
  • Park, Cheol-Joo (Department of Anesthesiology, College of Medicine, The Catholic University of Korea) ;
  • Kwon, Ou-Kyoung (Department of Anesthesiology, College of Medicine, The Catholic University of Korea) ;
  • Kim, Dae-Woo (Department of Anesthesiology, College of Medicine, The Catholic University of Korea) ;
  • Won, Chi-Hwan (Pain Clinic, St. Mary) ;
  • Kim, Sun-Cheol (Pain Clinic, St. Mary) ;
  • Chae, Hyeon (ChaeHyeon Pain Clinic) ;
  • Kim, Wook-Sung (Kimwooksung Pain Clinic)
  • 발행 : 1998.10.10

초록

Background: Opioids and local anesthetics have been administered epidurally for the purpose of the postoperative analgesia. However opioids have a serious risk of respiratory depression and local anesthetics have the risks of hypotension, sensory block, or motor one. In recent years, reports of spinal administration of midazolam for acute postoperative pain control have appeared in the literature. This study was performed to observe the effect of epidural midazolam in patient-controlled analgesia (PCA) device. Methods: Forty-five patients scheduled for the elective total hysterectomy were randomly selected; epidurally take morphine only (group I, n=15), morphine plus 0.1% bupivacaine (group II, n=15), or morphine plus midazolam (group III, n=15). The visual analogue scale (VAS) at rest and with movement, the sedation score, the degree of the satisfaction, the total amounts of a morphine usage, and the incidence of the side effects were observed. Rusults: The VAS at rest of group II and III were decreased significantly than that of group I. The VAS with movement of group III was significantly decreased than that of group I and II. The sadation score and the cumulative dose of a morphine were statistically insignificant within groups. Conclusion: Epidural morphine plus midazolam was proven to be clinically effective in the post-operative pain control especially for the pain with movement, compared with epidural morphine only and morphine plus 0.1% bupivacaine.

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