Comparison of Prophylactic Antiemetic Therapy with Patient-controlled Epidural Analgesia after Thoracotomy / 대한마취과학회지

ABSTRACT

BACKGROUND: Patient controlled analgesia (PCA) has become an important means for treating postoperative pain. However, postoperative nausea and vomiting (PONV) are a major problem for patient using PCA system. This study was designed to evaluate the efficacy of two prophylactic antiemetic regimens on PONV during PCA after lobectomy. METHODS: Sixty five patients, who underwent lobectomy and received a mixture of 0.18% ropivacaine at 0.5 microgram/kg/hr of fentanyl (2,000 microgram) via thoracic epidural catheter. The study design was a prospective, randomized, double-blinded, placebo-controlled study. Group C was saline control group. In Group A or B, Nasea(R) (ramosetron) or Zofran(R) (ondansetron) was administered as an intravenous bolus at completion of operation. We assessed the frequency and severity of PONV at 6, 24, 48 hours after anesthesia. Postoperative pain was assessed 6 hr after the operation and everyday for 6 days on visual analog scale (VAS). Postoperative side effects and patient satisfaction for epidural analgesia were assessed by 4 grades. RESULTS: PONV occurred in 20%, 20%, and 35% of patients in Group A, B, and C at 6 hr after anesthesia, and 12%, 30%, and 30% at 24 hr after anesthesia. There were no significantly statistical differences among three groups. The VAS scores during coughing were higher than those of resting state without intergroup difference. There were no serious clinical adverse events caused by the study drug and epidurally administered drugs in any study groups. CONCLUSIONS: This study found that ramosetron and ondansetron for preventing PONV during epidural PCA after lobectomy was not different from placebo control.