Medicine
Abdolreza Mehdinavaz Aghdam; Fariborz Rousta
Abstract
Introduction: NSAIDs are widely used in the treatment of back pain as they avoid most of the side effects of opioids such as respiratory depression, sedation, hallucinations, euphoria, addiction, shortening of bowel movements, periods and constipation. They are mostly used for mild to moderate pain where ...
Read More
Introduction: NSAIDs are widely used in the treatment of back pain as they avoid most of the side effects of opioids such as respiratory depression, sedation, hallucinations, euphoria, addiction, shortening of bowel movements, periods and constipation. They are mostly used for mild to moderate pain where patients can tolerate oral medications. Ketorolac trometamol is a parenteral NSAID, thus eliminating the need for patients to avoid entering the body, which is a problem immediately after abdominal surgery. Ketorolac inhibits prostaglandin synthesis by inhibiting the cyclooxygenase system. Material and Methods: At PACU, patients receive morphine at the discretion of the counseling program. All patients were given PCA morphine (1 mg bolus, 5 min lockout, 4-hour limit 30 mg) after discharge from the unit. Medicated analgesia is administered by the Pain Unit and stopped on the third postoperative day if the patient is urinating, has used less than 30 mg of morphine in the last 12 hours, and has less than 4/10 pain. During this time, all patients received 500 mg of BID oral naproxen supplemented with 1000 mg of oral acetaminophen every 6 hours.Results: The ketorolac group held this drug until day 6, when all eight patients were hospitalized. Two patients in the ketorolac group developed anastomotic leakage early after surgery and their care was excluded from further analysis due to significant differences in the study. The first leak occurred 4 days later in a 37-year-old man who had undergone a sigmoidectomy for diverticulitis with peritonitis. Conclusion: The main effect of short hospital stay is uncertain, possibly due to insufficient power for early decision making. Anastomotic leakage rate was higher than normal, especially in the ketorolac group, but there is no example of this in other studies and we can only evaluate it as negative.
