The Korean Journal of Pain

  • 제18권1호
  • /
  • Pages.19-22
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  • 2005
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  • 2005-9159(pISSN)
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  • 2093-0569(eISSN)
대한통증학회 (The Korean Pain Society)
권호 표지

경막외 카테터 피하매몰법을 이용한 지속적 모르핀 투여에 의한 말기암 환자의 통증관리

Cancer Pain Management by Continuous Epidural Morphine Infusion via Subcutaneous Tunneling

  • 류시정 (고신대학교 의과대학 마취통증의학교실) ;
  • 최형규 (고신대학교 의과대학 마취통증의학교실) ;
  • 김준영 (고신대학교 의과대학 마취통증의학교실) ;
  • 김두식 (고신대학교 의과대학 마취통증의학교실) ;
  • 장태호 (고신대학교 의과대학 마취통증의학교실) ;
  • 김세환 (고신대학교 의과대학 마취통증의학교실) ;
  • 김경한 (고신대학교 의과대학 마취통증의학교실)
  • Ryu, Sie Jeong (Department of Anesthesiology and Pain Medicine, College of Medicine, Kosin University) ;
  • Choi, Hyung Kyu (Department of Anesthesiology and Pain Medicine, College of Medicine, Kosin University) ;
  • Kim, Jun Young (Department of Anesthesiology and Pain Medicine, College of Medicine, Kosin University) ;
  • Kim, Doo Sik (Department of Anesthesiology and Pain Medicine, College of Medicine, Kosin University) ;
  • Jang, Tae Ho (Department of Anesthesiology and Pain Medicine, College of Medicine, Kosin University) ;
  • Kim, Se Hwan (Department of Anesthesiology and Pain Medicine, College of Medicine, Kosin University) ;
  • Kim, Kyung Han (Department of Anesthesiology and Pain Medicine, College of Medicine, Kosin University)
  • 투고 : 2005.03.03
  • 심사 : 2005.05.12
  • 발행 : 2005.06.30
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초록

Background: Most terminal cancer patients suffered from intractable pain. For the treatment of these patients, opioids, via various routes, are usually administered. Continuous epidural opioid, especially morphine, administration is a good method for the management of intractable cancer pain. Methods: We retrospectively analyzed 347 terminal cancer patients, who had been treated with continuous epidural morphine infusion, between 1999 and 2004. For the epidural infusion, an epidural catheter was inserted, tunneled subcutaneously and exited from the anterior chest or abdomen. Multiday $Infursor^{(R)}$ (Baxter, 0.5 ml/h) was used for the continuous infusion. Results: Of the 347 patients studied, there were 211 males and 136 females. The mean treatment time was 54.7 days, ranging from 5 to 481 days. The mean starting and termination doses of morphine were 32.4 (for 5 days) and 100.0 mg, respectively. The doubling time of the morphine dose was 26.3 days, corresponded to a 3.8 percent increase per day. Incidental catheter removal was the most common side effect, which occurred 130 times in 61 cases. Conclusions: The procedure of epidural catheterization, with subcutaneous tunneling, was simple and inexpensive. Despite the disadvantages, such as incidental catheter removal, it is a useful method for the control of terminal cancer pain.

키워드

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