술 중 Remifentanil 지속정주가 복강경 담낭절제술 후 진통제 사용에 미치는 영향

Background: This study was designed to evaluate the effect of intraoperative remifentanil infusion on postoperative analgesics requirements after laparoscopic cholecystectomy. Methods: One hundred adult patients scheduled for elective laparoscopic cholecystectomy were enrolled. Patients were randomly allocated to 2 groups to receive sevoflurane with remifentanil infusion (Group R) or not (group C). Sevoflurane concentration and remifentanil dose were adjusted to maintain BIS 40-60 and blood pressure within 20% of the preoperative value, respectively. We assessed the pain intensity by using the four-point verbal rating scale (VRS) (0=no pain. 1=slight pain, 2=moderate pain, 3=intense or severe pain) at 15 min intervals for 1 hour in recovery room and then at 3-h intervals for 24 h in surgical ward. The analgesic medication was given when VRS score was ≥2 or patients requested it. Results: There were no differences between the two groups with respect to the requirements for postoperative analgesics in recovery room and surgical ward. Conclusions: Continuous remifentanil infusion (0.09±0.05 ug/kg/min) during laparoscopic cholecystectomy does not cause hyperalgesia and more analgesic requirements. (Korean J Anesthesiol 2009;57:161∼4)