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91.
BACKGROUND: Glucocorticoids are known to provide slower onset and more prolonged duration of analgesic effect than ketorolac. In the present study, we wanted to evaluate the effect over time from a single dose of either intravenous (i.v.) dexamethasone or an intramuscular (i.m.) depot formulation of betamethasone compared with i.v. ketorolac. MATERIALS AND METHODS: One hundred and seventy-nine patients admitted for mixed ambulatory surgery were included in the study. After induction of general i.v. anaesthesia, the patients were randomized to receive double-blindly either dexamethasone 4 mg i.v. (Group D) or betamethasone depot formulation 12 mg i.m. (Group B) or ketorolac 30 mg i.v. (Group K). Fentanyl was used for rescue analgesic medication in the post-operative care unit (PACU) and codeine with paracetamol after discharge, for a study period of 3 days. RESULTS: There was significantly less post-operative pain in the ketorolac group during the stay in the unit (88% with minor or less pain in Group K vs. 74% and 67% in Groups D and B, respectively, P < 0.05), significantly less need for rescue medication (P < 0.05) and significantly less nausea or vomiting (12% in Group K vs. 30% in the other groups pooled, P < 0.05). The ketorolac patients were significantly faster for ready discharge, median 165 min vs. 192 min and 203 min in Groups D and B, respectively (P < 0.01). There were no differences between the groups in perceived pain, nausea, vomiting or rescue analgesic consumption in the 4- to 72-h period. CONCLUSION: Dexamethasone 4 mg or bethamethasone 12 mg did not provide prolonged post-operative analgesic effect compared with ketorolac 30 mg, which was superior for analgesia and antiemesis in the PACU. 相似文献
92.
BackgroundHepatectomy elaborates significant post-operative pain. Opioids represent cornerstone for post-operative analgesia in such cases. This study examined the therapeutic effect and outcome of adding low dose ketorolac tromethamine infusion to PO intravenous patient controlled fentanyl analgesia IV-PCA.Patients and methodsSixty right lobe donors were randomized into either fentanyl or ketorolac groups (30 patients each). Patients in both groups received fentanyl (2 μg/ml) solution in normal saline as IV-PCA with background infusion in a rate adjusted to deliver 0.25 μg kg h?1 and boluses of 10 ml with a lock-out time of 20 min. They received 15 mg ketorolac IV bolus in ketorolac group and similar placebo injection in the control. Patients in both groups received a continuous intravenous infusion of 240 ml normal saline solution that is either free in the FENT group or containing 60 mg ketorolac in ketorolac group, adjusted to a rate of 0.2 ml kg h?1. Visual analogue score (VAS) and hemodynamic profile were recorded at 1, 6, 12, 24, 36 and 48 h while laboratory results were recorded after 48 h and 7 days post-operatively.ResultsVAS was significantly lower in ketorolac group compared to fentanyl group from 6 to 36 h post-operatively while sedation score was significantly higher in fentanyl group compared to fentanyl–ketorolac group between 12 and 36 h post-operatively. Fentanyl consumption was significantly lower in ketorolac group at 24 (318.7 ± 66 vs 468.3 ± 79) and 48 (211.5 ± 59 vs 369.1 ± 68) h. Hemodynamic data and laboratory parameters were comparable in both groups. Nausea had a significantly higher incidence in FENT compared to KETR groups while other complications (vomiting and blood loss) were homogenous in both groups.ConclusionAdding ketorolac to IV PCA fentanyl improved the analgesic state and reduced the dose of fentanyl used without adding any side effects or risks to donors subjected to right lobe hepatectomy. 相似文献
93.
BackgroundKetorolac is a nonsteroidal anti-inflammatory drug used as part of multimodal analgesia in women undergoing cesarean delivery. The lowest effective dose of ketorolac that best optimizes analgesia without increasing side effects is unclear. We performed this retrospective study to compare the analgesic efficacy of 15 mg or 30 mg ketorolac administered intra-operatively to our obstetric population.MethodsWe included patients who underwent cesarean delivery under neuraxial anesthesia and received 15 mg or 30 mg of ketorolac intra-operatively. Our multimodal analgesic regimen is standardized and includes 150 µg spinal or 3 mg epidural morphine, 975 mg rectal acetaminophen, and 15–30 mg intravenous ketorolac within 15 min of surgery completion. The primary outcome was opioid use in the first 6 h after surgery. Secondary outcomes were opioid use at 24 and 48 h, opioid dose, pain scores, breastfeeding, postoperative serum creatinine and need for rescue anti-emetics.ResultsOne-thousand-three-hundred and forty-nine patients were analyzed (15 mg ketorolac n=999; 30 mg n=350). There was no difference between the two groups in patient demographics or intra-operative characteristics. There was no significant difference between groups for opioid use at 6 h after surgery (50.3% vs 52.0%, odds ratio [95% confidence interval] 1.13 [0.87 to 1.47]). There were also no significant differences between the groups for secondary outcomes.ConclusionsThere was no difference in opioid use between patients receiving either a 15 mg or a 30 mg dose of ketorolac given intra-operatively for postoperative analgesia following cesarean delivery. 相似文献
94.
目的探讨酮咯酸氨丁三醇在经阴道四维子宫输卵管超声造影(TVS 4D-HyCoSy)中的超前镇痛作用。 方法选取2018年5月至2019年3月于云南省第三人民医院因不孕症拟行TVS 4D-HyCoSy的患者102例。依据检查前使用镇痛药物的不同,将其分为观察组(造影前半小时肌内注射酮咯酸氨丁三醇)51例和对照组(造影前半小时肌内注射阿托品)51例,比较2组的镇痛效果及不良反应发生率。 结果观察组镇痛总有效率为96.1%(49/51),对照组总有效率为82.4%(42/51)。观察组显效3例,有效46例,无效2例;对照组有效42例,无效9例,无一例显效。观察组超前镇痛效果优于对照组(Z=-2.707,P=0.007)。观察组不良反应发生率较对照组低(3.9% vs 23.5%),差异有统计学意义(χ2=8.279,P=0.004)。 结论TVS 4D-HyCoSy前使用酮咯酸氨丁三醇超前镇痛的效果优于阿托品,值得临床推广运用。 相似文献
95.
96.
酮咯酸氨丁三醇治疗外科疾病疼痛118例 总被引:10,自引:0,他引:10
目的;探讨酮咯酸氨丁三醇对外科疾病疼痛的镇痛效果.方法;外科疾病疼痛患者118例,给予酮咯酸氨丁三醇注射液30 mg,im,口服剂10~20 mg,po,每天最大剂量不超过120 mg,对剧烈疼痛给药30 min后无效者,可再肌内注射30 mg.结果;起效时间5~60 min,平均35 min,止痛时间为0.5~24 h,平均8.2 h.总有效率97.5%.结论;酮咯酸氨丁三醇镇痛抗炎作用显著,并且起效迅速,可用于临床各种外科性疼痛. 相似文献
97.
98.
目的:探讨酮咯酸氨丁三醇联合山莨菪碱治疗肾绞痛的疗效。方法选取2011—2013年沧州市中心医院急诊科收治的肾绞痛患者457例,随机分为治疗组(228例)与对照组(229例)。治疗组患者予以酮咯酸氨丁三醇联合山莨菪碱治疗,对照组患者予以盐酸哌替啶联合山莨菪碱治疗。观察两组患者临床疗效及不良反应(如恶心、呕吐、头晕、尿潴留、低血压、过敏等)发生情况。结果两组患者总有效率比较,差异无统计学意义( P >0.05);治疗组患者不良反应发生率低于对照组,差异有统计学意义(P <0.05)。结论酮咯酸氨丁三醇联合山莨菪碱治疗肾绞痛的疗效显著,且不良反应少,安全性高。 相似文献
99.
Margherita Salaris Maria Nieddu Nicola Rubattu Cecilia Testa Elvira Luongo Maria Grazia Rimoli Gianpiero Boatto 《Journal of pharmaceutical and biomedical analysis》2010
The stability of ketorolac tromethamine was investigated in acid (0.5 M HCl) and alkaline conditions (0.5 M NaOH), using the same procedure reported by Devarajan et al. [2]. The acid and base degradation products were identified by liquid chromatography–mass spectrometry (LC–MS). 相似文献
100.