開胸術後疼痛に対する胸腔内局麻剤注入法の効果について
開胸術後の疼痛対策として胸腔内局麻剤注入法 (interpleur alanaigsia 以下IPA) の有効性を, 硬膜外麻酔単独群 (Epi群) と硬膜外麻酔にIPAを併用した群 (IPA群) の2群に分けて検討した。対象は33例で, 硬膜外麻酔には塩酸ブプレノルフィン0.2mgを用いた.閉胸時, ダブルルーメントロッカールを胸腔内に留麗し, IPA群にはこの薬剤注入用ルーメンから局麻剤 (0.25%ブビバカイン20ml) を注入した.Epi, IPA 施行前, 施行後6時間までの癖痛評価と, 血中ブビバカイン濃度を測定した.疹痛評価には Visual analogscale (VAS)...
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| Published in | 日本呼吸器外科学会雑誌 Vol. 11; no. 5; pp. 609 - 613 |
|---|---|
| Main Authors | , , , , |
| Format | Journal Article |
| Language | English Japanese |
| Published |
特定非営利活動法人 日本呼吸器外科学会
15.07.1997
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0919-0945 1881-4158 |
| DOI | 10.2995/jacsurg.11.609 |
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| Abstract | 開胸術後の疼痛対策として胸腔内局麻剤注入法 (interpleur alanaigsia 以下IPA) の有効性を, 硬膜外麻酔単独群 (Epi群) と硬膜外麻酔にIPAを併用した群 (IPA群) の2群に分けて検討した。対象は33例で, 硬膜外麻酔には塩酸ブプレノルフィン0.2mgを用いた.閉胸時, ダブルルーメントロッカールを胸腔内に留麗し, IPA群にはこの薬剤注入用ルーメンから局麻剤 (0.25%ブビバカイン20ml) を注入した.Epi, IPA 施行前, 施行後6時間までの癖痛評価と, 血中ブビバカイン濃度を測定した.疹痛評価には Visual analogscale (VAS) と PrinceHenry painscore (PH) を用いた.VAS, PH どちらの評価でもIPA群で有意に疼痛は軽度であった.血中ブビバカイン濃度はIPA施行後1時間でピーク値に達した後低下し, 全経過で安全範囲内であった.以上から開胸術後疼痛対策としてIPAは簡伸で右用で魅ると考えられた. |
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| AbstractList | 開胸術後の疼痛対策として胸腔内局麻剤注入法 (interpleur alanaigsia 以下IPA) の有効性を, 硬膜外麻酔単独群 (Epi群) と硬膜外麻酔にIPAを併用した群 (IPA群) の2群に分けて検討した。対象は33例で, 硬膜外麻酔には塩酸ブプレノルフィン0.2mgを用いた.閉胸時, ダブルルーメントロッカールを胸腔内に留麗し, IPA群にはこの薬剤注入用ルーメンから局麻剤 (0.25%ブビバカイン20ml) を注入した.Epi, IPA 施行前, 施行後6時間までの癖痛評価と, 血中ブビバカイン濃度を測定した.疹痛評価には Visual analogscale (VAS) と PrinceHenry painscore (PH) を用いた.VAS, PH どちらの評価でもIPA群で有意に疼痛は軽度であった.血中ブビバカイン濃度はIPA施行後1時間でピーク値に達した後低下し, 全経過で安全範囲内であった.以上から開胸術後疼痛対策としてIPAは簡伸で右用で魅ると考えられた. |
| Author | 笹井, 巧 五味淵, 誠 真崎, 義隆 田中, 茂夫 原口, 秀司 |
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| References | 3) Reiestad F, Stromskag KE, Holmqvist E : Interpleural administration of bupivacaine in postoperative management of pain. Anesthesiology 65 : A 204, 1986. 5) Scott NB, Mogensen T, Bigler D et al : Comparison of the effects of continuous interpleural vs epidural administration of 0.5% bupivacaine on pain, metabolic response and pulmonary function following cholecystectomy. Acta Anaesthesiol Scand 33 : 535-539, 1989. 1) Kvalheim L, Reiestad F : Local anesthesia and pain. Anesthesiology 61 : A 231, 1984. 7) Lee VC, Abram SE : Interpleural administration of bupivacaine for post-thoracotomy analgesia. Anesthesiology 66 : 586, 1987. 19) Shantha TR : Unilateral bronchospasm after interpleural analgesia. Anesth Analg 74 : 291-293, 1992. 8) Kanbam JR, Hammon J, Parris WCV et al : Interpleural analgesia for postthoracotomy pain and blood levels of bupivacaine following Interpleural injection. Can J Anaesth 36 : 106-109, 1989. 9) Rosenberg PH, Scheinin BMA, Lepantalo MJA et al : Continuous interpleural infusion of bupivacaine for analgesia after thoracotomy. Anesthesiology 67 : 811-813, 1987. 17) Parkinson SK, Mueller JB, Rich TJ, et al. : Unilateral Horner's syndrome associated with interpleural catheter injection of local anesthetic. Anesth Analg 68 : 61-62, 1989. 6) Kambam JR, Handte RE, Flanagan J, et al : Interpleural anesthesia for post thoracotomy pain relief. Anesth Analg 66 : S 90, 1987. 10) El-Baz N, Faber LP, Ivankovich AD : Interpleural infusion of local anesthetic : a word caution. Anesthesiology 68 : 809-810, 1988. 12) Stromskag KE, Minor B, Steen PA : Side effects and complications to interpleural analgesia : an update. Acta Anaesthesiol Scand 34 : 473-477, 1990. 13) Blake DW, Donnan G, Novella J : Interpleural administration of bupibacaine after cholecystectomy : a comparison with intercostal nerve block. Anaesth Intensive Care 17 : 269-274, 1989. 16) 山本健 : Interpleural analgesia. 日臨床麻酔会誌 11 : 287-294, 1991. 4) Reiestad F, Stromskag KE : Interpleural catheter in the management of postoperative pain. A preliminary report. Reg Anesth 11 : 89-91, 1986. 14) van Kleef JW, Burm AG Vletter AA : Single-dose interpeural versus intercostal blockade : nerve block characteristics and plasma concentration profiles after administration of 0.5% bupivacaine with epinephrine. Anesth Analg 70 : 484-488, 1990. 11) Ferrante FM, Chan VWS, Arthur GR et al : Interpreural analgesia after thoracotomy. Anesth Analg 72 : 105-109, 1991. 2) Selzer J, Larijani GE, Goldberg ME, et al : Interpleural bupivacaine-a kinetic and dynamic evaluation. Anesthesiology 67 : 798-800, 1987. 15) Thompson SE, Johnson JM : Analgesia in dogs after intercostal thoracotomy. A comparison of morphine, selective intercostalnerve block, and interpleural regional analgsia with bupivacaine. Vet Surg 20 : 73-77, 1991. 18) Aguilar J, Montero A, Lopez FV, et al. : Intrapleural analgesia and phrenic nerve palsy (letter). Reg Anaesth 13 : 45, 1990. 20) Joseph WB, Curtis GT : Pleural anesthetics given through an epidural catheter secured inside a chest tube. Ann Thorac Surg 51 : 138-139, 1991. |
| References_xml | – reference: 6) Kambam JR, Handte RE, Flanagan J, et al : Interpleural anesthesia for post thoracotomy pain relief. Anesth Analg 66 : S 90, 1987. – reference: 9) Rosenberg PH, Scheinin BMA, Lepantalo MJA et al : Continuous interpleural infusion of bupivacaine for analgesia after thoracotomy. Anesthesiology 67 : 811-813, 1987. – reference: 12) Stromskag KE, Minor B, Steen PA : Side effects and complications to interpleural analgesia : an update. Acta Anaesthesiol Scand 34 : 473-477, 1990. – reference: 3) Reiestad F, Stromskag KE, Holmqvist E : Interpleural administration of bupivacaine in postoperative management of pain. Anesthesiology 65 : A 204, 1986. – reference: 2) Selzer J, Larijani GE, Goldberg ME, et al : Interpleural bupivacaine-a kinetic and dynamic evaluation. Anesthesiology 67 : 798-800, 1987. – reference: 18) Aguilar J, Montero A, Lopez FV, et al. : Intrapleural analgesia and phrenic nerve palsy (letter). Reg Anaesth 13 : 45, 1990. – reference: 4) Reiestad F, Stromskag KE : Interpleural catheter in the management of postoperative pain. A preliminary report. Reg Anesth 11 : 89-91, 1986. – reference: 8) Kanbam JR, Hammon J, Parris WCV et al : Interpleural analgesia for postthoracotomy pain and blood levels of bupivacaine following Interpleural injection. Can J Anaesth 36 : 106-109, 1989. – reference: 10) El-Baz N, Faber LP, Ivankovich AD : Interpleural infusion of local anesthetic : a word caution. Anesthesiology 68 : 809-810, 1988. – reference: 1) Kvalheim L, Reiestad F : Local anesthesia and pain. Anesthesiology 61 : A 231, 1984. – reference: 13) Blake DW, Donnan G, Novella J : Interpleural administration of bupibacaine after cholecystectomy : a comparison with intercostal nerve block. Anaesth Intensive Care 17 : 269-274, 1989. – reference: 15) Thompson SE, Johnson JM : Analgesia in dogs after intercostal thoracotomy. A comparison of morphine, selective intercostalnerve block, and interpleural regional analgsia with bupivacaine. Vet Surg 20 : 73-77, 1991. – reference: 16) 山本健 : Interpleural analgesia. 日臨床麻酔会誌 11 : 287-294, 1991. – reference: 5) Scott NB, Mogensen T, Bigler D et al : Comparison of the effects of continuous interpleural vs epidural administration of 0.5% bupivacaine on pain, metabolic response and pulmonary function following cholecystectomy. Acta Anaesthesiol Scand 33 : 535-539, 1989. – reference: 19) Shantha TR : Unilateral bronchospasm after interpleural analgesia. Anesth Analg 74 : 291-293, 1992. – reference: 20) Joseph WB, Curtis GT : Pleural anesthetics given through an epidural catheter secured inside a chest tube. Ann Thorac Surg 51 : 138-139, 1991. – reference: 11) Ferrante FM, Chan VWS, Arthur GR et al : Interpreural analgesia after thoracotomy. Anesth Analg 72 : 105-109, 1991. – reference: 14) van Kleef JW, Burm AG Vletter AA : Single-dose interpeural versus intercostal blockade : nerve block characteristics and plasma concentration profiles after administration of 0.5% bupivacaine with epinephrine. Anesth Analg 70 : 484-488, 1990. – reference: 7) Lee VC, Abram SE : Interpleural administration of bupivacaine for post-thoracotomy analgesia. Anesthesiology 66 : 586, 1987. – reference: 17) Parkinson SK, Mueller JB, Rich TJ, et al. : Unilateral Horner's syndrome associated with interpleural catheter injection of local anesthetic. Anesth Analg 68 : 61-62, 1989. |
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| Snippet | 開胸術後の疼痛対策として胸腔内局麻剤注入法 (interpleur alanaigsia 以下IPA) の有効性を, 硬膜外麻酔単独群 (Epi群) と硬膜外麻酔にIPAを併用した群 (IPA群) の2群に分けて検討した。対象は33例で, 硬膜外麻酔には塩酸ブプレノルフィン0.2mgを用いた.閉胸時,... |
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| SubjectTerms | 胸腔内局麻剤注入法 (IPA) 術後疼痛 開胸術 |
| Title | 開胸術後疼痛に対する胸腔内局麻剤注入法の効果について |
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