دورية أكاديمية
أعرض في EDS

Intraoperative ketorolac for pediatric tonsillectomy: Effect on post-tonsillectomy hemorrhage and perioperative analgesia.

التفاصيل البيبلوغرافية
العنوان: Intraoperative ketorolac for pediatric tonsillectomy: Effect on post-tonsillectomy hemorrhage and perioperative analgesia.
المؤلفون: Rabbani CC; Department of Otolaryngology-Head and Neck Surgery, USA., Pflum ZE; Department of Otolaryngology-Head and Neck Surgery, USA., Ye MJ; Department of Otolaryngology-Head and Neck Surgery, USA., Gettelfinger JD; Department of Otolaryngology-Head and Neck Surgery, USA., Sadhasivam S; Department of Anesthesia, Indiana University School of Medicine, Indianapolis, IN, USA., Matt BH; Department of Otolaryngology-Head and Neck Surgery, USA., Dahl JP; Department of Otolaryngology-Head and Neck Surgery, USA. Electronic address: john.dahl@seattlechildrens.org.
المصدر: International journal of pediatric otorhinolaryngology [Int J Pediatr Otorhinolaryngol] 2020 Nov; Vol. 138, pp. 110341. Date of Electronic Publication: 2020 Aug 28.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Elsevier Scientific Publishers Country of Publication: Ireland NLM ID: 8003603 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1872-8464 (Electronic) Linking ISSN: 01655876 NLM ISO Abbreviation: Int J Pediatr Otorhinolaryngol Subsets: MEDLINE
أسماء مطبوعة: Publication: Limerick : Elsevier Scientific Publishers
Original Publication: [Amsterdam] Elsevier/North-Holland.
مواضيع طبية MeSH: Analgesics, Opioid/*therapeutic use , Anti-Inflammatory Agents, Non-Steroidal/*therapeutic use , Hemorrhage/*etiology , Ketorolac/*therapeutic use , Postoperative Hemorrhage/*etiology , Tonsillectomy/*adverse effects, Adenoidectomy/adverse effects ; Analgesics, Opioid/administration & dosage ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Intraoperative Care ; Male ; Pain, Postoperative/etiology ; Postoperative Hemorrhage/surgery ; Postoperative Period ; Retrospective Studies ; Time Factors
مستخلص: Objective: Determine the impact of ketorolac on post-tonsillectomy hemorrhage (PTH) and narcotic administration in children undergoing tonsillectomy.
Methods: Retrospective case series from 2013 to 2017. Patients younger than 18 years undergoing tonsillectomy were included. PTH was the primary outcome measured. Secondary measures include percentage of patients requiring surgical intervention for PTH, average time to PTH, the number of post-operative opioid doses, and average post-operative opioid dose. Statistical methods include Chi-square, Wilcoxon rank sum, and binary logistic regression analyses.
Results: During the study period, 669 patients received a single intraoperative dose of ketorolac (K+) and 653 patients did not receive ketorolac (K-). No differences were found in the rate of PTH (K- 6.5% vs. K+ 5.3%, RR = 0.82, 95% CI = 0.53 to 1.29, p = 0.40), surgical control of PTH (K- 4.0% vs. K+ 3.5%, RR = 0.87, CI = 0.51 to 1.51, p = 0.62), or average time [SD] to PTH (K- 6.0 [4.2] vs. K+ 5.2 [4.9] days; difference = 0.8 days; 95% CI, -1.3 to 2.9; p = 0.45). K+ patients had fewer post-operative opioid doses [SD] (K- 1.86 [1.14] vs. K+ 1.59 [1.23]; difference = -0.27; 95% CI, -0.053 to -0.49, Cohen d = 0.23) and a lower average opioid dose [SD] (K- 0.041 [0.032] vs. K+ 0.035 [0.030] mg/kg; difference = -0.006 mg/kg; 95% CI, -0.0003 to -0.012; Cohen d = 0.19).
Conclusion: Ketorolac did not increase risk of hemorrhage following tonsillectomy and decreased narcotic use.
(Copyright © 2020 Elsevier B.V. All rights reserved.)
التعليقات: Comment in: Int J Pediatr Otorhinolaryngol. 2021 Mar;142:110589. (PMID: 33386147)
Comment in: Int J Pediatr Otorhinolaryngol. 2021 Mar;142:110588. (PMID: 33436271)
معلومات مُعتمدة: R01 HD089458 United States HD NICHD NIH HHS; R21 HD094311 United States HD NICHD NIH HHS
فهرسة مساهمة: Keywords: Bleeding; Ketorolac; Pain; Tonsillectomy
المشرفين على المادة: 0 (Analgesics, Opioid)
0 (Anti-Inflammatory Agents, Non-Steroidal)
YZI5105V0L (Ketorolac)
تواريخ الأحداث: Date Created: 20200906 Date Completed: 20210331 Latest Revision: 20220520
رمز التحديث: 20240628
DOI: 10.1016/j.ijporl.2020.110341
PMID: 32891944
قاعدة البيانات: MEDLINE
الوصف
تدمد:1872-8464
DOI:10.1016/j.ijporl.2020.110341