Surgical Invasiveness is Important for Determining Severity of Postoperative Pain after Oral & Maxillofacial Surgery

구강악안면 수술의 침습도 및 술 후 통증의 정도와의 상관성

  • Shin, Teo-Jeon (Department of Dental Anesthesiology and Dental Research Institute, School of Dentistry, Seoul National University) ;
  • Park, Yun-Ki (Department of Dental Anesthesiology and Dental Research Institute, School of Dentistry, Seoul National University) ;
  • Seo, Kwang-Suk (Department of Dental Anesthesiology and Dental Research Institute, School of Dentistry, Seoul National University) ;
  • Han, Hyo-Jo (Department of Dental Anesthesiology and Dental Research Institute, School of Dentistry, Seoul National University) ;
  • Kim, Hyun-Jeong (Department of Dental Anesthesiology and Dental Research Institute, School of Dentistry, Seoul National University)
  • 신터전 (서울대학교 치의과대학원 치과마취과학교실) ;
  • 박윤기 (서울대학교 치의과대학원 치과마취과학교실) ;
  • 서광석 (서울대학교 치의과대학원 치과마취과학교실) ;
  • 한효조 (서울대학교 치의과대학원 치과마취과학교실) ;
  • 김현정 (서울대학교 치의과대학원 치과마취과학교실)
  • Received : 2011.06.03
  • Accepted : 2011.06.17
  • Published : 2011.06.30

Abstract

배경: 술 후 통증은 술 후 합병증의 발생가능성을 증가시키며 생체기능의 회복을 방해한다. 술 후 통증을 효과적으로 조절하기 위해선 통증의 정도를 객관적으로 평가하는 것이 필요하다. 술 후 통증은 수술의 침습도와 관련이 높을 가능성이 많다. 본 연구에서는 수술 침습도의 정도와 술 후 통증의 정도 사이의 상관관계를 확인하고자 한다. 방법: 총 153명의 환자를 수술의 침습도에 따라 4개의 그룹으로 나누었다(그룹 1: 악성종양 수술 (malignancy surgery), 그룹 2: 양악수술(bimaxillary surgery), 그룹 3: 양성 종양수술(benign cancer surgery) 그룹 4: 임플란트 & 골절 수술(implant & frature)) 수술이 끝나갈 무렵 fentanyl 700 ${\mu}g$, ketorolac 1,500 mg (총 용적 120 ml)가 포함된 자가통증조절장치를 정맥로에 연결하였다. 술 후 통증의 정도는 시각통증등급(visual analogue scale)을 이용하여 측정하였고 자가통증조절장치의 총 사용시간, 투여된 진통제의 양, bolus 투여 총 횟수를 측정하였다. 결과: 술 후 시각통증등급은 술 후 1일부터 3일까지 그룹 1, 2 군에서 유의하게 높았다. 또한 시각통증등급 3점 이상의 통증을 호소하는 환자의 비율 역시 그룹 1, 2 군에서 유의하게 높았다. 진통제 총 투여용량 및 자가로 주입한 진통제의 양 역시 그룹 1, 2군에서 3, 4 군에 비해 유의하게 높은 것을 확인하였다. 결론: 본 연구결과 외과적 수술의 침습도가 술 후 통증의 정도를 결정하는데 있어 중요한 요소임 을 확인하였다.

Keywords

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