The Efficacy of Programmed Intermittent Epidural Bolus for Postoperative Analgesia after Open Gynecological Surgery : A Randomized Double-Blinded Study

• 資料種別: 博士論文
• ISSN: 2314-6133
• タイトル: The Efficacy of Programmed Intermittent Epidural Bolus for Postoperative Analgesia after Open Gynecological Surgery : A Randomized Double-Blinded Study
• 巻次・部編番号: 2018
• 著者・編者: Satomi, Shiho; Kakuta, Nami; Murakami, Chiaki; Sakai, Yoko; Tanaka, Katsuya; Tsutsumi, Yasuo M.
• 著者標目: Satomi, Shiho; Kakuta, Nami; Murakami, Chiaki; Sakai, Yoko; Tanaka, Katsuya; Tsutsumi, Yasuo M.
• 出版事項: Hindawi
• 出版年月日等: 2018-05-15
• 出版年（W3CDTF）: 2018-05-15
• 並列タイトル等: 開腹婦人科手術での術後鎮痛における硬膜外間欠投与の有効性
• タイトル（掲載誌）: BioMed Research International
• 授与機関名: 徳島大学
• 授与年月日: 2019-03-22
• 授与年月日（W3CDTF）: 2019-03-22
• 報告番号: 甲第3250号
• 学位: 博士（医学）
• 博論授与番号: 甲第3250号
• 本文の言語コード: eng
• 件名標目: General anesthesia; Open surgery; PIEB
• 対象利用者: 一般
• 一般注記: Background. It is well known that the programmed intermittent epidural bolus (PIEB) technique effectively provides epidural anesthesia in labor. This randomized double-blind trial compared the postoperative analgesic efficacy of PIEB with that of continuous epidural infusion (CEI) in patients undergoing gynecological surgery under combined general-epidural anesthesia. Methods. Patients undergoing open gynecological surgery under combined general-epidural anesthesia were randomized at a 1 : 1 ratio to receive PIEB or CEI. In the PIEB group, the pump delivered 4mL ropivacaine 0.2% plus fentanyl 2 ?g/mL every hour. In the CEI group, the pump delivered the same solution at a rate of 4 mL/h. In both groups, additional 4mL boluses of ropivacaine 0.2% plus fentanyl 2 ?g/mL were provided, when necessary, by patient-controlled epidural analgesia after surgery. The primary outcome was the total ropivacaine dose 40 hours after surgery. The secondary outcomes were the number of PCEA boluses and postoperative pain (evaluated on an 11-point numerical rating scale) 3, 24, and 48 hours after surgery. Results. In total, 57 patients were randomized (? = 28 and 29 in the PIEB and CEI groups, resp.). The two groups differ significantly in terms of the total ropivacaine dose 40 hours after surgery (mean (standard deviation): 155.38 (4.55) versus 159.73 (7.87) mL, ? = 0.016). Compared to the CEI group, the PIEB group had significantly lower numerical rating scale scores 3 hours (median [lower–upper quartiles]: 0 [0–0.5] versus 3 [0–5.5], ? = 0.002), 24 hours (1 [0–2] versus 3 [1–4], ? = 0.003), and 48 hours (1 [0–2] versus 2 [2–3.5], ? = 0.002) after surgery. Conclusion. PIEB was better than CEI in terms of providing postoperative analgesia after open gynecological surgery under combined general-epidural anesthesia.
• DOI: info:doi/10.1155/2018/6297247; https://doi.org/info:doi/10.1155/2018/6297247
• 国立国会図書館永続的識別子: info:ndljp/pid/11300290; https://dl.ndl.go.jp/pid/11300290
• コレクション（共通）: 障害者向け資料
• コレクション（障害者向け資料：レベル1）: テキストデータ
• コレクション（個別）: 国立国会図書館デジタルコレクション > デジタル化資料 > 博士論文; https://dl.ndl.go.jp/collections/A00014
• 収集根拠: 博士論文（自動収集）
• 受理日（W3CDTF）: 2019-07-05T01:13:02+09:00
• 記録形式（IMT）: application/pdf
• オンライン閲覧公開範囲: 国立国会図書館内限定公開
• デジタル化資料送信: 図書館・個人送信対象外
• 遠隔複写可否（NDL）: 可
• 掲載誌（URI）: http://repo.lib.tokushima-u.ac.jp/113336
• 連携機関・データベース: 国立国会図書館 : 国立国会図書館デジタルコレクション; https://dl.ndl.go.jp