• The Korean Journal of Pain
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• 제13권2호
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• pp.255-258
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• 2000

Epidural morphine is effective in the treatment of postoperative pain, but side effects, such as nausea, vomiting, pruritus and urinary retention commonly occur. Droperidol is frequently used as an antiemetic to prevent intraoperative and postoperative vomiting. But it has been reported to cause acute extrapyramidal effects including dystonia. We report one case of acute dystonia in young adult following the use of epidural droperidol.

• The Korean Journal of Pain
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• 제11권1호
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• pp.86-90
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• 1998

Background: There are no controlled studies assessing the effect of metoclopramide and droperidol administered epidurally for the prevention of nausea and vomiting associated with epidural morphine. This study was undertaken to compare the effectiveness of continuous epidural metoclopramide and droperidol in reducing nausea and vomiting associated with epidural morphine. Methods: Ninty patients undergoing elective gynecologic surgery were randomly assigned to one of three study groups; Group A(n=30) patients received continuous infusion of epidural morphine(6.0 mg/day) following a bolus loading dose of 3.0 mg; Group B(n=30), epidural mixture of morphine and droperidol(5.0 mg/day) following a bolus loading dose(morphine 3.0 mg, droperidol 1.5 mg); Group C, (n=30), epidural mixture of morphine and metoclopramide(20 mg/day) following a bolus loading dose(morphine 3.0 mg, metoclopramide 10 mg). For the 24 postoperative hours, the incidence of nausea and vomiting, degree of pain, level of sedation and other adverse effects were evaluated. Results: Incidence of nausea and vomiting, and number of patients who required antiemetic therapy were significantly less in Group B and C than in Group A(P<0.05). Patients in Group A and C were less sedated than those in Group B. Conclusions: We conclude metoclopramide is more effective than droperidol for postoperative nausea and vomiting due to its lower of sedative effect.

• The Korean Journal of Pain
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• 제10권1호
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• pp.42-47
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• 1997

Background : This study was designed to evaluate the continuous effects of single intravenous injection of antiemetics on nausea and vomiting during continuous morphine injection for postoperative pain control. Methods : Prior to the study, we divided patients into two major groups according to the type of surgery performed intra-abdominal(Open: O) and non intra-abdominal(Close: C). When patients regained orientation after routine general anesthesia, enflurane-$O_2-N_2O$, we injected bolus dose of morphine and started continuous injection of morphine for postoperative pain control(Group I; Control). After bolus injection and just before continuous injection, we injected single dose of droperidol(Group II) or ondansetron(Group III). Mean arterial blood pressure, heart rate, pain score and symptom-therapy score were checked at 10 minutes, 4, 8, 16, 24, 36 hours after continuous morphine injection. Results : The pain score of group III was lower than group II(10 min.) and group I(24, 36 hours) in the open group. Symptom-therapy score of group III(10 min., 4, 24 hours) and group II(10 min.) were lower than group I in the open group. In the close group, symptom-therapy score of group III(8 hours) was lower than group I. Conclusions : Single intravenous injection of antiemetics have a tendency of lowering symptom-therapy score for 36 hours in spite of their relatively short elimination half-life.

• The Korean Journal of Pain
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• 제11권1호
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• pp.91-95
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• 1998

Background: Quality of postoperative care may be improved by management of postoperative pain. Epidural anesthesia and analgesia have several advantages over general anesthesia and parenteral analgesics in managing the postoperative pain. We retrospectively reviewed records of obstetrical patients who underwent the cesarean sections under epidural anesthesia to evaluate perioperative analgesic use, side effects, and complications. Methods: All patients received epidural anesthesia consisting of 0.25% bupivacaine, 2% lidocaine and 100 ${\mu}g$ fentanyl, followed by epidural analgesia with 0.1% bupivacaine and 12.5 ${\mu}g$/ml fentanyl at rate of 2 ml/hr for 48 hours. Patients' records were reviewed for: medications administered for pain relief, incidence of nausea and vomiting and pruritus, and presence of respiratory or cardiovascular depression. Results: Over 18 months, 1,054 patients' records were reviewed. Average age was 27.8 years (18~43 years). 768 patients (72.9%) received no additional drugs for the pain relief. Intramuscular analgesics, ketoprofens, were one time administered to 247 patients (23.4%), 39 patients (3.7%) received two more dosages. The time of administration was $8.3{\pm}4.3$ hours postoperatively. Antiemetics, for example, low-dose droperidol, were administerd one time for 160 patients (15.2%), 5 patients (0.5%) received two or more administrations. The medication was administered $5.1{\pm}4.2$ hours postoperatively. Drugs for relief of pruritus, low-dose naloxone, were administered one time for 108 patients (10.2%), 10 patients (0.9%) received 2 or more dosages. The time of administration was $6.3{\pm}4.2$ hours postoperatively. None of the patients experienced cardiovascular nor respiratory (<8 breath/min) depression. Conclusions: Postoperative continuous epidural analgesia in combination with bupivacaine and fentanyl is an effective method of providing postoperative analgesia with low incidence of side effects.