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凯托洛拉克不会增加术后出血,并限制在接受囊内桃体切除术的儿科患者中使用麻醉剂
Elizabeth D Fisher1, Julia Gm Carter2, Michelle Tsao3
1Northwestern University Feinberg School of Medicine, Department of Otolaryngology, Chicago, IL, USA.
外科手术期间使用的凯托洛拉克在儿童中没有增加桃体切除术后出血率. 接受凯托洛拉克的患者经历了较少的疼痛和更短的PACU停留时间,减少了阿片类药物的使用.
科学领域:
- 儿科麻醉学 儿科麻醉学
- 疼痛管理 疼痛管理
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
背景情况:
- 关于儿科内囊性桃体切除术中的外科外科桃体安全性存在相互矛盾的证据.
- 由于安全问题,一些供应商避免使用ketorolac.
- 新出现的证据表明,凯托洛拉克在这种人群中可能安全用于疼痛控制.
研究的目的:
- 为了评估经过囊内桃体切除术的儿童的外科手术期间 ketorolac 的安全性和有效性.
- 为了比较接受桃体切除术后出血 (PTH) 发生率的患者和未接受桃体切除术的患者.
- 评估二次结果,包括疼痛再入院,PACU时间和阿片类药物管理.
主要方法:
- 在单个中心进行回顾性队列研究.
- 包括1594名接受囊内桃体切除术的儿童.
- 在接受外科手术期间托拉克和未接受托拉克的儿童之间比较结果.
主要成果:
- 需要操作控制的PTH率没有显著差异 (0.7%对1.4%,p=0.1415).
- 术后疼痛再入院率没有差异 (2.0%对3.1%,p=0.167).
- 凯托洛拉克组的PACU时间减少了13.4% (48 vs 58分钟,p<0.001) 和阿片类MME减少 (3.7 vs 5.3,p<0.001).
结论:
- 在外科手术期间的凯托洛拉克与儿科内囊性桃体切除术中PTH增加无关.
- 凯托洛拉克的使用与减少阿片类药物消费和更短的PACU停留相关.
- 需要进一步的前性试验来证实这些发现.
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