Continuous Infusion Ketorolac for Postoperative Analgesia Following Unilateral Total Knee Arthroplasty

Schwinghammer, Amy J; Isaacs, Alex N.; Benner, Rodney W.; Freeman, Heather; O'Sullivan, Jacob A; Nisly, Sarah A.

doi:10.1177/1060028017694655

Cited by 19 publications

(17 citation statements)

References 22 publications

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“…Ketorolac (KET), a nonsteroidal antiinflammatory drug (NSAID), has been proved to have antiinflammation and opioid-sparing properties with fewer complications (8,9).…”

Section: Postoperative Analgesiamentioning

confidence: 99%

“…KET has toxicity effects on the GI, renal, and blood systems, the risk factors of which include usage beyond 5 days, age beyond 65 years, and history of GI bleeding or ulceration (9). In several studies using KET for PCIA, a regimen with fewer complications was recommended (that is a bolus dose of 30 mg followed by continuous infusion of 3.6 mg/h KET) (8,9).…”

Section: Group Time Cd3 + T(%) Cd4 + T(%) Cd8 + T(%) Cd4 + T/cd8 + T mentioning

confidence: 99%

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hole-Course Application of Dexmedetomidine Combined with Ketorolac in Nonnarcotic Postoperative Analgesia for Patients with Lung Cancer Undergoing Thoracoscopic Surgery: A Randomized Control Trial

Wen

2020

Pain Phys

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BACKGROUND: Opioid-based postoperative analgesia provides adequate analgesia with much adverse effects and immunosuppression. Dexmedetomidine and ketorolac have properties of opioid-sparing, antiinflammation, and immune protection. OBJECTIVES: To investigate the efficacy and safety of whole-course application of dexmedetomidine combined with ketorolac in nonnarcotic postoperative analgesia and its effect on inflammatory response and immune function in thoracoscopic surgery of lung cancer. STUDY DESIGN: Double-blind, randomized control trial. SETTING: The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China. METHODS: Sixty patients scheduled for thoracoscopic surgery were enrolled and randomly divided into 2 groups to receive a combination of intraoperative usage of dexmedetomidine and postoperative patient-controlled intravenous analgesia of dexmedetomidine 0.1 µg/kg/h and ketorolac 3 mg/kg (DEX group) or only postoperative patient-controlled intravenous analgesia of sufentanil 1.5 µg/kg and ketorolac 3 mg/kg (SUF group) for 48 hours. Vital signs, postoperative Visual Analog Scale (VAS) score, Ramsay sedation score, patient-controlled analgesia pressing times, consumption of sufentanil and rescue drug, and complications were compared between the 2 groups. The levels of inflammatory factors and immune function were also compared. RESULTS: A significant reduction in median blood pressures and heart rates within 48 hours after surgery and perioperative consumption of sufentanil were observed in the DEX group compared with the SUF group (P < 0.05). No statistically significant difference was found in VAS scores, patient-controlled analgesia pressing times, and rescue drug consumption between the 2 groups (P > 0.05). The incidence of nausea was significantly lower in the DEX group compared with the SUF group (P < 0.05). A significant decrease of interleukin (IL)-1 beta, IL-6, tumor necrosis factor (TNF)-alpha, and increased CD4+ and CD4+/CD8+ were observed in the DEX group compared with the SUF group at 24 and 48 hours after surgery (P < 0.05). There was no difference in the levels of CD8+ and natural killer cells between the 2 groups (P > 0.05). LIMITATIONS: This study was limited by its sample size. CONCLUSIONS: Whole-course application of dexmedetomidine combined with ketorolac in nonnarcotic postoperative analgesia provided adequate and safe postoperative analgesia, reduced sufentanil consumption, analgesia-related complications, alleviated inflammatory response, and immunosuppression compared with sufentanil-based analgesia in thoracoscopic surgery. KEY WORDS: Dexmedetomidine, ketorolac, sufentanil, thoracoscopic surgery, postoperative analgesic, patient-controlled analgesia, inflammatory response, immune function

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“…Ketorolac (KET), a nonsteroidal antiinflammatory drug (NSAID), has been proved to have antiinflammation and opioid-sparing properties with fewer complications (8,9).…”

Section: Postoperative Analgesiamentioning

confidence: 99%

Section: Group Time Cd3 + T(%) Cd4 + T(%) Cd8 + T(%) Cd4 + T/cd8 + T mentioning

confidence: 99%

hole-Course Application of Dexmedetomidine Combined with Ketorolac in Nonnarcotic Postoperative Analgesia for Patients with Lung Cancer Undergoing Thoracoscopic Surgery: A Randomized Control Trial

Wen

2020

Pain Phys

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“…Fentanil adalah analgetik golongan opioid, yang mana biasanya digunakan untuk menurunkan rasa nyeri, namun memiliki beberapa efek samping 13 . Ketorolak diketahui dapat menurunkan nyeri pasca operasi dan menunjukkan insidensi sedasi yang lebih rendah dibandingkan dengan petidin [14][15][16] . Berdasarkan penelitian, efek analgetik ketorolak lebih baik dibandingkan dengan tramadol dan nalbupin 17,18 .…”

Section: Pendahuluanunclassified

Luaran Terapi Berdasarkan Jenis Pemberian Analgetik pada Pasien Pasca Operasi Ortopedi

Windari

Ikawati

Purwaningtyastuti

2020

J. Manaj. dan Pelayanan Farm.

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Postoperative pain was suffered by 80% of the total patients. One of the many surgical procedures performed is orthopedics. Ketorolac and fentanyl are often used for postoperative orthopedic pain. Appropriate postoperative pain management with adequate analgesic administration will accelerate pain reduction and shorten the patient's hospital stay. This study aims to determine the difference in the effect of continuous fentanyl and intravenous ketorolac on pain targets achievement and Length of Stay (LOS) of patients after orthopedic surgery. This study is a prospective cohort study, involving inpatients after orthopedic surgery in Dr. Sardjito Yogyakarta in July-October 2019. The independent variable is continuous fentanyl and intravenous ketorolac, while the dependent variable is the achievement of pain targets and LOS. The analysis was conducted by Fisher's exact test, Mann Whitney's test, and multivariate analysis to determine the dominance of variables on the research outcomes. There were 59 patients after orthopedic surgery in this study. A total of 34 patients in the continuous fentanyil group and 25 patients in the intravenous ketorolac group. There was no difference in the effect of continuous fentanyl administration and intravenous ketorolac on pain targets achievement (P = 0.711), while there were differences in the effect of continuous fentanyl administration and intravenous ketorolac on the average LOS of patients in the hospital (P = 0,000). Continuous fentanyl and intravenous ketorolac can both produce the achievement of adequate postoperative orthopedic pain targets, but the mean LOS becomes shorter in patients with intravenous ketorolac.

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“…Peri articular injection of local anesthetics is a possible means of achieving this objective. The length of the hospital stay as well as the rehabilitation is well controlled by the use of atleast two analgesics with different mechanism of actions which is termed as multimodal analgesia [20].…”

Section: Analgesic Protocol In Patients Undergoing Tkrmentioning

confidence: 99%

Quality of life in total knee replacement (TKR) patients – A review

Priya

Karthika

Shibu

et al. 2020

JAPR

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Continuous Infusion Ketorolac for Postoperative Analgesia Following Unilateral Total Knee Arthroplasty

Abstract: Postoperative CI ketorolac improved pain control while reducing opioid consumption and adverse effects.

Cited by 19 publications

References 22 publications

hole-Course Application of Dexmedetomidine Combined with Ketorolac in Nonnarcotic Postoperative Analgesia for Patients with Lung Cancer Undergoing Thoracoscopic Surgery: A Randomized Control Trial

hole-Course Application of Dexmedetomidine Combined with Ketorolac in Nonnarcotic Postoperative Analgesia for Patients with Lung Cancer Undergoing Thoracoscopic Surgery: A Randomized Control Trial

Luaran Terapi Berdasarkan Jenis Pemberian Analgetik pada Pasien Pasca Operasi Ortopedi

Quality of life in total knee replacement (TKR) patients – A review

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