Comparison of Postoperative Intravenous Patient-controlled Analgesia for Postcesarean Patients-Opioids Alone Versus Ketorolac Plus Low Dose Opioids

剖腹產後的病人使用Ketorolac加上低劑量opioids與單獨使用opioids作為術後患者靜脈自控式止痛的比較

徐士哲(Shih-Che Hsu) ； 洪維德(Wei-Te Hung) ； 劉哲銘(Cher-Ming Liou) ； 陳慶祺(Ching-Chi Chen)

《中山醫學雜誌》 16卷1期 (2005/06) Pp. 53-58

https://doi.org/10.30096/CSMJ.200506.0007

摘要

Background: Ketorolac is known to be effective in releasing uterine cramping pain common in post cesarean section patients. This study was designed to compare the analgesic effects and adverse effects of ketorolac plus low dose opioids as opposed to opioids alone in patients receiving intravenous patient-controlled analgesia after cesarean section.
Methods: Patients who received postoperative intravenous patient-controlled analgesia were randomly assigned to two groups: (A) ketorolac 1.03 mg/ml) +fentanyl (4.31 μg/ml) +morphine (0.172 mg/ml), (B) fentanyl (15 μg/ml) +morphine (0.5 mg/ml). During the postoperative 72-hour period pain intensity was evaluated with verbal rating scale (VRS) on a scale of 0-4 (from ”none” to ”excruciating”), and side effects were recorded.
Results: No statistical difference (P＞0.05) was found in VRS scores. Significantly higher side effects were found in Group B (drowsy, dizziness, nausea, vomiting).
Conclusions: The ketorolac group (Group A) received the same postoperative analgesic effect, on lower dosage opiates and with lower side effects than the opiate group (Group B). We suggest use of ketorolac to replace some opioids for postoperative analgesia when no contraindications for NSAID5 use are present.

關鍵字

剖腹產 ； morphine ； fentanyl ； ketorolac ； 非類固醇類抗發炎藥物 ； 患者自控式止痛

並列摘要

Background: Ketorolac is known to be effective in releasing uterine cramping pain common in post cesarean section patients. This study was designed to compare the analgesic effects and adverse effects of ketorolac plus low dose opioids as opposed to opioids alone in patients receiving intravenous patient-controlled analgesia after cesarean section.
Methods: Patients who received postoperative intravenous patient-controlled analgesia were randomly assigned to two groups: (A) ketorolac 1.03 mg/ml) +fentanyl (4.31 μg/ml) +morphine (0.172 mg/ml), (B) fentanyl (15 μg/ml) +morphine (0.5 mg/ml). During the postoperative 72-hour period pain intensity was evaluated with verbal rating scale (VRS) on a scale of 0-4 (from ”none” to ”excruciating”), and side effects were recorded.
Results: No statistical difference (P＞0.05) was found in VRS scores. Significantly higher side effects were found in Group B (drowsy, dizziness, nausea, vomiting).
Conclusions: The ketorolac group (Group A) received the same postoperative analgesic effect, on lower dosage opiates and with lower side effects than the opiate group (Group B). We suggest use of ketorolac to replace some opioids for postoperative analgesia when no contraindications for NSAID5 use are present.

並列關鍵字

cesarean section ； morphine ； fentanyl ； ketorolac ； nonsteroidal anti-inflammatory drugs ； patient-controlled analgesia