대장 절제술에서 수술 중 N-acetyl-cysteine의 투여가 수술 후 회복 시간에 미치는 영향

• Published in: Korean journal of anesthesiology Vol. 51; no. 4; pp. 436 - 442
• Main Authors: 하인호, In Ho Ha, 곽경화, Kyung Hwa Kwak, 한창규, Chang Gyu Han, 이인택, In Taek Lee, 최규석, Gyu Seog Choi, 김인겸, In Kyeom Kim, 백운이, Woon Yi Baek, 임동건, Dong Gun Lim
• Format: Journal Article
• Language: Korean
• Published: 대한마취통증의학회(구 대한마취과학회) 30.10.2006; 대한마취통증의학회
• Subjects: Laparoscopic surgery; N-acetyl-cysteine; oxidative stress; postanesthetic recovery; 마취과학
• ISSN: 2005-6419; 2005-7563

Background: The gut is an important area for inflammatory responses. Gut manipulation during open laparotomy compared with laparoscopic surgery, increases the inflammatory responses. Laparoscopic assisted colectomy (LC) with less bowel manipulation might minimize the inflammatory responses and oxidative stress, and offer a faster postanesthetic recovery than an open colectomy (OC). This study evaluated the effect of N-acetyl-cysteine (NAC), an antioxidant, on the recovery after colectomy. Methods: 116 colorectal tumor patients were reviewed retrospectively. The patients were divided into 3 groups; LC by surgeon A (A－L), OC by surgeon A (A－O) and OC by surgeon B (B－O). The postanesthetic recovery scores (PARS) were compared. In the prospective randomized controlled trial, the colorectal tumor patients were assigned to one of four groups; laparoscopic assisted colectomy (L － N) with NAC infusion (L + N), open colectomy (O-N) with NAC infusion (O + N). In the NAC groups, NAC (5 mg/kg/h) was infused after intubation to extubation. The PARS were compared. Results: In the retrospective study, the time to reach 10 points, which satisfies the discharge criteria in the PACU, was significantly lower in the A－L group than in the other groups. In the prospective study, the time to 10 points was shorter in the O + N group than in the O－N group. NAC offered no added benefits to the L + N and L－N groups. Conclusions: NAC offered faster recovery in the OC group but not in the LC group. (Korean J Anesthesiol 2006; 51: 436~42)