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    Please use this identifier to cite or link to this item: https://ir.cnu.edu.tw/handle/310902800/32321


    標題: Analgesic Effects of Locally Administered Ketorolac-based Analgesics After Breast Surgery A Meta-Analysis of Randomized Controlled Trials
    作者: Chen, Jen-Yin
    Feng, I-Jung
    Loh, El-Wui
    Wang, Li-Kai
    Lin, Chao-Chun
    Tam, Ka-Wai
    貢獻者: Chi Mei Med Ctr, Dept Anesthesiol
    Chi Mei Med Ctr, Dept Med Res
    Chia Nan Univ Pharm & Sci, Dept Senior Citizen Serv Management
    Taipei Med Univ, Shuang Ho Hosp, Ctr Evidence Based Hlth Care
    Taipei Med Univ, Shuang Ho Hosp, Div Gen Surg, Dept Surg
    Taipei Med Univ, Sch Med, Dept Surg, Coll Med
    Taipei Med Univ, Cochrane Taiwan
    關鍵字: ketorolac
    local anesthesia
    infiltration
    breast surgery
    postoperative pain
    meta-analysis
    日期: 2018-06
    上傳時間: 2019-12-16 09:35:34 (UTC+8)
    出版者: LIPPINCOTT WILLIAMS & WILKINS
    摘要: Objective: Reducing postoperative pain following breast surgery is crucial for rapid recovery and shortening hospital stay. Ketorolac, a nonsteroidal anti-inflammatory drug, has been used as a postoperative analgesic in many surgical procedures. We conducted a systemic review and meta-analysis on the efficacy of locally administered ketorolac-based analgesics in managing pain after breast surgery. Methods: We searched the PubMed, Embase, Cochrane Library, Scopus, and ClinicalTrials.gov registry for randomized control trials (RCTs) published up to September 2016. The primary outcome was pain level assessed using a visual analog scale (VAS) at 1 and 6 hours following breast surgery. Results: We reviewed 4 RCTs with 255 patients. For meta-analysis, VAS at 1 and 6 hours of 3 similar RCTs were compared. At 1 hour, VAS scores were significantly lower in patients administered a ketorolac solution [weighted mean difference (WMD) = -2.04; 95% confidence interval (CI): -3.08 to -1.00] or ketorolac-bupivacaine solution (WMD = -2.30; 95% CI, -4.07 to -0.54) than in controls. At 6 hours, the ketorolac-bupivacaine solution reduced VAS scores significantly (WMD = -1.40; 95% CI, -2.48 to -0.32) compared with controls. However, at 1 hour, the ketorolac solution was significantly more effective than the bupivacaine solution was (WMD = -1.70; 95% CI, -2.81 to -0.59). Discussion: The effects of ketorolac-based analgesics vary as per the surgery and disease type. Locally administered ketorolac-based analgesics decreased postoperative pain in breast surgery patients, and the effect of local ketorolac was better than local bupivacaine. Therefore, ketorolac-based analgesics demonstrate considerable local infiltration during pain management after breast surgery.
    link: http://dx.doi.org/10.1097/AJP.0000000000000556
    關聯: Medicine, v.34, n.6, pp.577-584
    Appears in Collections:[高齡福祉養生管理系] 期刊論文

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