治疗术后疼痛的常规Ketorolac使用不会增加经过子宫切除术后出血的风险
Grace M Pipes1, Rebecca J Schneyer2, Kacey M Hamilton2
1Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
Journal of clinical medicine
|January 28, 2026
概括
开托洛拉克在切除子宫术后对疼痛控制是安全的,并且不会增加出血风险. 这种非类固醇抗炎药物可以作为治疗术后疼痛的阿片类药物节约选择.
科学领域:
- 产科和妇科 产科和妇科
- 麻醉学 麻醉学
- 手术结果研究研究.
背景情况:
- 凯托洛拉克是一种有效的止痛药,但存在潜在的术后出血风险.
- 在切除子宫的患者中,基托洛拉克的出血风险尚未先前评估.
- 这项研究涉及基托洛拉克在妇科手术,特别是子宫切除术中的安全性.
研究的目的:
- 为了评估术后出血并发症的风险,与切除子宫术后的基托洛拉克的使用有关.
- 为了确定使用凯托洛拉克是否会增加输血,再接收或经过子宫切除术后出血的重新手术的可能性.
- 在子宫切除术的背景下,评估凯托洛拉克作为阿片类药物节约剂的安全性.
主要方法:
- 对4236名因良性征兆而接受子宫切除术的患者进行了回顾性队列研究 (2015-2024).
- 分析包括多变量回归以调整诸如年龄,ASA类别,切莱科西布使用,抗凝血,子宫大小,手术方法,复杂性和粘附溶解等因素.
- 主要结局:术后出血并发症 (输血,再入院,重新手术) 的组合.
主要成果:
- 76%的患者接受了手术后的凯托洛拉克.
- 基托洛拉克组的复合出血率较低 (2.1%对4.1%,p=0.001).
- 多变量分析显示,使用凯托洛拉克与增加出血风险 (aOR 1.02) 之间没有关联. 大型外科手术期间的并发症和腹的可能性较小,而 ketorolac.
结论:
- 开托洛拉克的使用与子宫切除术后出血并发症的风险增加无关.
- 凯托洛拉克可以安全地作为阿片类药物节省止痛药在接受子宫切除术的患者中使用.
- 研究结果支持使用凯托洛拉克,即使在增强恢复协议中使用赛莱科克西布进行手术前.
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