Analgesic Effects of Locally Administered Ketorolac-based Analgesics After Breast Surgery A Meta-Analysis of Randomized Controlled Trials

doi:10.1097/AJP.0000000000000556

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Title:	Analgesic Effects of Locally Administered Ketorolac-based Analgesics After Breast Surgery A Meta-Analysis of Randomized Controlled Trials
Authors:	Chen, Jen-Yin Feng, I-Jung Loh, El-Wui Wang, Li-Kai Lin, Chao-Chun Tam, Ka-Wai
Contributors:	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
Keywords:	ketorolac local anesthesia infiltration breast surgery postoperative pain meta-analysis
Date:	2018-06
Issue Date:	2019-12-16 09:35:34 (UTC+8)
Publisher:	LIPPINCOTT WILLIAMS & WILKINS
Abstract:	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.
???metadata.dc.relation.uri???:	http://dx.doi.org/10.1097/AJP.0000000000000556
Relation:	Medicine, v.34, n.6, pp.577-584
Appears in Collections:	[Dept. of Senior Service and Health Management] Periodical Articles

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