Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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Comparison of an Additional Transdermal Fentanyl Patch Compared to Intravenous NSAID and Opioid Analgesics within 24 Hours of an Uterine Artery Embolization for Myoma and Adenomyosis

자궁근종과 자궁선근증 치료를 위한 자궁동맥색전술 후 24시간 이내의 통증 조절에 대한 경피 펜타닐 패치의 효과

  • Song, Sook-Yun (Department of Radiology, Mokdong Hospital, Ewha Womans University School of Medicine) ;
  • Kang, Byung-Chul (Department of Radiology, Mokdong Hospital, Ewha Womans University School of Medicine) ;
  • Rho, Kyung-Min (Department of Radiology, Mokdong Hospital, Ewha Womans University School of Medicine)
  • 송숙연 (이화여자대학교 의과대학 목동병원 영상의학과) ;
  • 강병철 (이화여자대학교 의과대학 목동병원 영상의학과) ;
  • 노경민 (이화여자대학교 의과대학 목동병원 영상의학과)
  • Published : 2011.05.01
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Abstract

Purpose: To evaluate the effectiveness of an additional transdermal fentanyl patch compared to intravenous analgesics in pain control during the 24-hour period following uterine artery embolization (UAE) for myoma and adenomyosis. Materials and Methods: Between September 2009 and August 2010, 42 patients underwent UAE for myoma or adenomyosis. Of these, 21 received an intravenous opioid (pethidine) and a nonsteroidal anti-inflammatory drug (group A), and 21 received an additional transdermal fentanyl patch (group B). Pain perception levels were established verbally on a 0-10 scale during the 24-hour period following UAE. Differences in pain trends, mean dose of intravenous pethidine, and adverse effects were compared between the two groups. Results: Pain perception was most severe at 6 hours after UAE and the mean pain level of group B at that time was 6.3 ${\pm}$ 0.7, which was significantly lower than that of group A, 8.2 ${\pm}$ 0.7 (p<0.05). The mean dose of intravenous pethidine was 114.3 ${\pm}$ 59.5 mg in group A and 90.5 ${\pm}$ 49.0 mg in group B, while the incidence of nausea was 67% in group A and 77% in group B. In both cases, the differences were not significantly different (p>0.05), and no evidence of respiratory distress was demonstrated. Conclusion: The addition of a transdermal fentanyl patch to intravenous analgesics is effective in reducing post-embolization pain during the 24-hour period after UAE.

목적: 자궁근종과 자궁선근증 환자에서 자궁동맥색전술 시행 후 통증의 정도를 24시간 동안 평가하여 정맥 내 진통제와 함께 추가로 사용하는 경피 펜타닐 패치의 통증 조절에 대한 효과를 알아보았다. 대상과 방법: 자궁근종과 자궁선근증으로 자궁동맥색전술을 시행 받은 42명의 환자를 대상으로, 마약성 진통제 페티딘과 비스테로이드성 소염제를 정맥 내 투여받은 군(A군)과 추가로 경피 펜타닐 패치를 부착한 군(B군)으로 각각 21명씩 분류하였다. 색전술 시행 후 24시간 동안의 통증지각 정도를 구두통증척도에 따라 0-10점으로 평가하여 시간에 따른 통증 정도를 분석하였다. 또한, 두 군의 통증 정도, 페티딘 투여량, 부작용 발생을 비교하였다. 결과: 전체 환자에서 색전술 6시간 후에 통증의 정도가 가장 심했으며, 이때의 평균 구두통증척도는 A군 8.2 ${\pm}$ 0.7점, B군 6.3 ${\pm}$ 0.7점으로 유의한 차이가 있었다(p < 0.05). A군에서는 평균 114.3 ${\pm}$ 59.5 mg의 페티딘이 투여되었고 B군에서는 평균 90.5 ${\pm}$ 49.0 mg이 투여되었으나, 유의한 차이는 없었다(p=0.131). 오심의 발생은 A군에서 67%, B군에서 77%였으며 유의한 차이는 없었다(p=0.495). 호흡장애는 발생하지 않았다. 결론: 자궁동맥색전술 시행 후 24시간 이내의 통증 조절에 정맥 내 진통제에 추가로 경피 펜타닐 패치를 사용하는 것은 효과적이며 심각한 부작용을 일으키지 않았다.

Keywords

References

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