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      KCI등재 SCOPUS SCIE

      비뇨기과 수술을 받는 노인 환자의 척추마취 시 첨가된 Fentanyl의 용량에 따른 임상효과의 비교 = Comparison of clinical effect of intrathecally administered fentanyl for elderly patients undergoing urologic surgery

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      https://www.riss.kr/link?id=A104348499

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      다국어 초록 (Multilingual Abstract)

      Background: Spinal anesthesia for urologic surgery in elderly patients is preferred. The addition of opioids to local anesthetics reduces the side effects of spinal anesthesia. This study examined the effects of intrathecal fentanyl 10μg and 20μg when administered with hyperbaric 0.5% bupivacaine to elderly patients undergoing urologic surgery.
      Methods: Forty-five elderly patients undergoing urologic surgery were randomized into the following three groups: group 1, bupivacaine 7.5 mg; group 2, bupivacaine 5 mg + fentanyl 10μg; and group 3, bupivacanie 5 mg + fentanyl 20μg. The total volume of intrathecally injected was adjusted to 1.5 ml with sterile normal saline. Spinal anesthesia was administered with a 25 G Quincke needle at the L3−4 or L4−5 interspace in the lateral position. The neural block was assessed using a pinprick test and the Bromage scale.
      Results: There were no significant differences in the onset time of the T10 sensory block, peak level of the sensory block, and onset time of the peak level. The duration of the sensory block was significantly shorter in group 2 than in group 1 (P = 0.017). The duration of the motor block was longer in group 1 than in groups 2 and 3 (P = 0.016, P = 0.04). Pruritus was observed more often in group 3 (37.5%) and shivering was more common in group 1 (P = 0.005).
      Conclusions: The addition of fentanyl 10μg and 20μg to bupivacaine 5 mg provides adequate anesthesia for elderly patients undergoing urologic surgery with fewer side effects, and fentanyl 10μg is recommended as outpatient anesthesia.
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      Background: Spinal anesthesia for urologic surgery in elderly patients is preferred. The addition of opioids to local anesthetics reduces the side effects of spinal anesthesia. This study examined the effects of intrathecal fentanyl 10μg and 20μg...

      Background: Spinal anesthesia for urologic surgery in elderly patients is preferred. The addition of opioids to local anesthetics reduces the side effects of spinal anesthesia. This study examined the effects of intrathecal fentanyl 10μg and 20μg when administered with hyperbaric 0.5% bupivacaine to elderly patients undergoing urologic surgery.
      Methods: Forty-five elderly patients undergoing urologic surgery were randomized into the following three groups: group 1, bupivacaine 7.5 mg; group 2, bupivacaine 5 mg + fentanyl 10μg; and group 3, bupivacanie 5 mg + fentanyl 20μg. The total volume of intrathecally injected was adjusted to 1.5 ml with sterile normal saline. Spinal anesthesia was administered with a 25 G Quincke needle at the L3−4 or L4−5 interspace in the lateral position. The neural block was assessed using a pinprick test and the Bromage scale.
      Results: There were no significant differences in the onset time of the T10 sensory block, peak level of the sensory block, and onset time of the peak level. The duration of the sensory block was significantly shorter in group 2 than in group 1 (P = 0.017). The duration of the motor block was longer in group 1 than in groups 2 and 3 (P = 0.016, P = 0.04). Pruritus was observed more often in group 3 (37.5%) and shivering was more common in group 1 (P = 0.005).
      Conclusions: The addition of fentanyl 10μg and 20μg to bupivacaine 5 mg provides adequate anesthesia for elderly patients undergoing urologic surgery with fewer side effects, and fentanyl 10μg is recommended as outpatient anesthesia.

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      다국어 초록 (Multilingual Abstract)

      Background: Spinal anesthesia for urologic surgery in elderly patients is preferred. The addition of opioids to local anesthetics reduces the side effects of spinal anesthesia. This study examined the effects of intrathecal fentanyl 10μg and 20μg when administered with hyperbaric 0.5% bupivacaine to elderly patients undergoing urologic surgery.
      Methods: Forty-five elderly patients undergoing urologic surgery were randomized into the following three groups: group 1, bupivacaine 7.5 mg; group 2, bupivacaine 5 mg + fentanyl 10μg; and group 3, bupivacanie 5 mg + fentanyl 20μg. The total volume of intrathecally injected was adjusted to 1.5 ml with sterile normal saline. Spinal anesthesia was administered with a 25 G Quincke needle at the L3−4 or L4−5 interspace in the lateral position. The neural block was assessed using a pinprick test and the Bromage scale.
      Results: There were no significant differences in the onset time of the T10 sensory block, peak level of the sensory block, and onset time of the peak level. The duration of the sensory block was significantly shorter in group 2 than in group 1 (P = 0.017). The duration of the motor block was longer in group 1 than in groups 2 and 3 (P = 0.016, P = 0.04). Pruritus was observed more often in group 3 (37.5%) and shivering was more common in group 1 (P = 0.005).
      Conclusions: The addition of fentanyl 10μg and 20μg to bupivacaine 5 mg provides adequate anesthesia for elderly patients undergoing urologic surgery with fewer side effects, and fentanyl 10μg is recommended as outpatient anesthesia.
      번역하기

      Background: Spinal anesthesia for urologic surgery in elderly patients is preferred. The addition of opioids to local anesthetics reduces the side effects of spinal anesthesia. This study examined the effects of intrathecal fentanyl 10μg and 20μg...

      Background: Spinal anesthesia for urologic surgery in elderly patients is preferred. The addition of opioids to local anesthetics reduces the side effects of spinal anesthesia. This study examined the effects of intrathecal fentanyl 10μg and 20μg when administered with hyperbaric 0.5% bupivacaine to elderly patients undergoing urologic surgery.
      Methods: Forty-five elderly patients undergoing urologic surgery were randomized into the following three groups: group 1, bupivacaine 7.5 mg; group 2, bupivacaine 5 mg + fentanyl 10μg; and group 3, bupivacanie 5 mg + fentanyl 20μg. The total volume of intrathecally injected was adjusted to 1.5 ml with sterile normal saline. Spinal anesthesia was administered with a 25 G Quincke needle at the L3−4 or L4−5 interspace in the lateral position. The neural block was assessed using a pinprick test and the Bromage scale.
      Results: There were no significant differences in the onset time of the T10 sensory block, peak level of the sensory block, and onset time of the peak level. The duration of the sensory block was significantly shorter in group 2 than in group 1 (P = 0.017). The duration of the motor block was longer in group 1 than in groups 2 and 3 (P = 0.016, P = 0.04). Pruritus was observed more often in group 3 (37.5%) and shivering was more common in group 1 (P = 0.005).
      Conclusions: The addition of fentanyl 10μg and 20μg to bupivacaine 5 mg provides adequate anesthesia for elderly patients undergoing urologic surgery with fewer side effects, and fentanyl 10μg is recommended as outpatient anesthesia.

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      참고문헌 (Reference)

      1 김혜경, "비뇨기과 수술에서 Bupivacaine 척추마취에 첨가한 Fentanyl의 효과" 대한마취과학회 45 (45): 42-46, 2003

      2 곽경화, "경요도 전립선절제술에서 척추마취 시 소용량 Bupivacaine-Fentanyl의 병용투여와 상용용량 Bupivacaine의 임상 효과 비교" 대한마취과학회 43 (43): 418-423, 2002

      3 Varassi G, "Ventilatory effects of subarachnoid fentanyl in the elderly" 47 : 558-562, 1992

      4 Ozaki M, "Thermoregulatory thresholds during epidural and spinal anesthesia" 81 : 282-288, 1994

      5 Kurz A, "Thermoregulatory response thresholds during spinal anesthesia" 77 : 721-726, 1993

      6 Rathmell JP, "The role of intrathecal drugs in the treatment of acute pain" 101 : 30-43, 2005

      7 Chow TC, "The influence of small dose intrathecal fentanyl on shivering during transurethral resection of prostate under spinal anesthesia" 32 : 165-170, 1994

      8 Martyr JW, "Spinal-induced hypotension in elderly patients with hip fracture. A comparison of glucose-free bupivacaine with glucose-free bupivacaine and fentanyl" 33 : 64-68, 2005

      9 Kleinman W, "Spinal, epidural & caudal blocks. In: Clinical anesthesiology. 4th" 290-, 2005

      10 Lee GY, "Spinal anesthesia with 0.5% hyperbaric bupivacaine in elderly patients: influence of aging in spread of analgesia and blood pressure" 37 : 436-441, 1999

      1 김혜경, "비뇨기과 수술에서 Bupivacaine 척추마취에 첨가한 Fentanyl의 효과" 대한마취과학회 45 (45): 42-46, 2003

      2 곽경화, "경요도 전립선절제술에서 척추마취 시 소용량 Bupivacaine-Fentanyl의 병용투여와 상용용량 Bupivacaine의 임상 효과 비교" 대한마취과학회 43 (43): 418-423, 2002

      3 Varassi G, "Ventilatory effects of subarachnoid fentanyl in the elderly" 47 : 558-562, 1992

      4 Ozaki M, "Thermoregulatory thresholds during epidural and spinal anesthesia" 81 : 282-288, 1994

      5 Kurz A, "Thermoregulatory response thresholds during spinal anesthesia" 77 : 721-726, 1993

      6 Rathmell JP, "The role of intrathecal drugs in the treatment of acute pain" 101 : 30-43, 2005

      7 Chow TC, "The influence of small dose intrathecal fentanyl on shivering during transurethral resection of prostate under spinal anesthesia" 32 : 165-170, 1994

      8 Martyr JW, "Spinal-induced hypotension in elderly patients with hip fracture. A comparison of glucose-free bupivacaine with glucose-free bupivacaine and fentanyl" 33 : 64-68, 2005

      9 Kleinman W, "Spinal, epidural & caudal blocks. In: Clinical anesthesiology. 4th" 290-, 2005

      10 Lee GY, "Spinal anesthesia with 0.5% hyperbaric bupivacaine in elderly patients: influence of aging in spread of analgesia and blood pressure" 37 : 436-441, 1999

      11 Gurkan Y, "Prophylactic ondansetron reduces the incidence of intrathecal fentanyl-induced pruritus" 35 : 1763-1766, 2002

      12 Borgeat A, "Postoperative nausea and vomiting in regional anesthesia" 98 : 530-547, 2003

      13 Ergina P, "Perioperative care of the elderly patient" 17 : 192-198, 1993

      14 Warren DT, "Neuraxial anesthesia. In: Anesthesiology" 978-1008, 2008

      15 Forrest JB, "Multicenter study of general anesthesia III : predictors of severe adverse outcomes" 76 : 3-15, 1992

      16 Ben-David B, "Minidose bupivacaine-fentanyl spinal anesthesia for surgical repair of hip fracture in the aged" 92 : 6-10, 2000

      17 Kararmaz A, "Low-dose bupivacaine-fentanyl spinal anaesthesia for transurethral prostatectomy" 58 : 526-530, 2003

      18 Dahlgren G, "Intrathecal sufentanil, fentanyl, or placebo added to bupivacaine for Cesarean section" 85 : 1288-1293, 1997

      19 Manullang TR, "Intrathecal fentanyl is superior to intravenous ondansetron for the prevention of perioperative nausea during cesarean delivery with spinal anesthesia" 90 : 1162-1166, 2000

      20 Techanivate A, "Intrathecal fentanyl for prevention of shivering in cesarean section" 88 : 1214-1221, 2005

      21 Zohar E, "Intrathecal anesthesia for elderly patients undergoing short transurethral procedures: a dose-finding study" 104 : 552-554, 2007

      22 Baek SW, "Geriatiric anesthesia. In: Anesthesiology and Pain Medicine" Ryomungak 378-386, 2003

      23 Liu SS, "Dose-response characteristics of spinal bupivacaine in volunteers" 85 : 729-736, 1996

      24 Belzarena SD, "Clinical effects of intrathecally administered fentanyl in patients undergoing cesarean section" 74 : 653-657, 1992

      25 Choi DH, "A comparison of three doses of hyperbaric bupivacaine and the effects of fentanyl" 37 : 37-44, 1999

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