The Korean Journal of Pain

The Korean Pain Society (대한통증학회)
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Effects of Epidural Naloxone on Pruritus Induced by Hydromorphone Epidural Patient-Controlled Analgesia

경막외 Hydromorphone 자가조절진통에서 소양증에 대한 경막외 Naloxone의 효과

  • Bang, Si Ra (Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kim, Hee Suk (Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kim, Ji Hyeok (Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Sim, Woo Seok (Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Gwak, Mi Sook (Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Yang, Mi Kyung (Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kim, Chung Su (Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Hahm, Tae Soo (Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Cho, Hyun Sung (Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Choi, Duck Hwan (Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kim, Tae Hyeong (Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • 방시라 (성균관대학교 의과대학 삼성서울병원 마취통증의학교실) ;
  • 김희숙 (성균관대학교 의과대학 삼성서울병원 마취통증의학교실) ;
  • 김지혁 (성균관대학교 의과대학 삼성서울병원 마취통증의학교실) ;
  • 심우석 (성균관대학교 의과대학 삼성서울병원 마취통증의학교실) ;
  • 곽미숙 (성균관대학교 의과대학 삼성서울병원 마취통증의학교실) ;
  • 양미경 (성균관대학교 의과대학 삼성서울병원 마취통증의학교실) ;
  • 김정수 (성균관대학교 의과대학 삼성서울병원 마취통증의학교실) ;
  • 함태수 (성균관대학교 의과대학 삼성서울병원 마취통증의학교실) ;
  • 조현성 (성균관대학교 의과대학 삼성서울병원 마취통증의학교실) ;
  • 최덕환 (성균관대학교 의과대학 삼성서울병원 마취통증의학교실) ;
  • 김태형 (성균관대학교 의과대학 삼성서울병원 마취통증의학교실)
  • Received : 2006.02.24
  • Accepted : 2006.06.07
  • Published : 2006.06.30
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Abstract

Background: Opioid delivered by epidural patient-controlled analgesia (PCA) is effective in relieving pain after surgery, but it is associated with side effects, such as nausea, vomiting, pruritus, respiratory depression, and urinary retention. The purpose of this study was to compare hydromorphone related side effects and the quality of analgesia when naloxone was added to epidural PCA regimen. Methods: Fifty-two thoracotomy patients with PCA were allocated blindly into two groups. Patients in group H (n = 26) received continuous epidural hydromorphone ($16{\mu}g/ml$) in 0.1% bupivacaine; patients in group N (n = 26) received an epidural infusion containing naloxone ($2{\mu}g/ml$) and hydromorphone ($16{\mu}g/ml$) in 0.1% bupivacaine. The basal rate of PCA was 4 ml/hr and the demand dose was 1.5 ml with a lockout time of 15 min. Pain intensity, sedation, pruritus, nausea and vomiting, respiratory depression were checked at 6, 12, 24 hours postoperatively. Results: The Visual Analog Scale (VAS) scores were significantly lower in group H than in group N. There were no significant differences in the overall incidence of pruritus, nausea and sedation between the two groups. Conclusions: Continuous epidural infusion of naloxone combined with hydromorpho-ne is not effective in reducing the incidence and severity of pruritus induced by epidural hydromorphone.

Keywords

References

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